A clinical case of immune-mediated pneumonitis after nivolumab in a patient with Burkitt lymphoma
https://doi.org/10.17650/1818-8346-2023-18-1-121-125
Abstract
Immunotherapy is a promising method in the treatment of cancer. PD-1 (programmed cell death protein 1) receptor and its ligand, which contribute to the reactivation of T-cells exerting their cytotoxic function against the tumor, are one of the targets of antitumor drugs. The effectiveness of immune checkpoint inhibitors has been demonstrated in the treatment of melanoma and non-small cell lung cancer. The spectrum of side effects of antitumor immune drugs differs from the classical ones observed in the cytostatics treatment. Immune-mediated adverse events can affect multiple organs, including skin, gastrointestinal tract, endocrine and nervous systems, and lungs. Pneumonitis is a potentially life-threatening complication and often requires immediate administration of corticosteroids.
This article presents the case of a patient with relapsed Burkitt lymphoma treated with nivolumab and R-ICE (rituximab, ifosfamide etoposide, carboplatin) scheme. The therapy was effective, but complicated by immune-mediated pneumonitis. Corticosteroids administration resolved this complication and anti-cancer treatment was completed. The following nivolumab administrations were free of side effects.
About the Authors
K. I. Utesheva
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
Kristina Igorevna Utesheva
115478, Moscow, Kashirskoe Shosse, 24
T. T. Valiev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
115478, Moscow, Kashirskoe Shosse, 24
O. A. Ignatenko
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
115478, Moscow, Kashirskoe Shosse, 24
S. V. Goryacheva
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
115478, Moscow, Kashirskoe Shosse, 24
N. A. Batmanova
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
115478, Moscow, Kashirskoe Shosse, 24
K. I. Kirgizov
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
115478, Moscow, Kashirskoe Shosse, 24
References
1. Valiev T.T. Burkitt lymphoma in children: 30 year treatment expirience. Pediatriya. Zhurnal im. G.N. Speranskogo = Pediatria. Journal named after G.N. Speransky 2020;99(4):35–42. (In Russ.).
2. Moleti M.L., Testi A.M., Foa R. Treatment of relapsed/refractory paediatric aggressive B-cell non-Hodgkin lymphomas. Br J Hematol 2020;189(5):826–43. DOI:10.1111/bjh.16461
3. Polaskova K., Merta T., Martincekova A. et al. Comprehensive molecutar profiling for relapsed/refractory pediatric Burkitt lymphomas – retrospective analysis of three real-life clinical cases – addressing issues on randomization and customization at the bedside. Front Oncol 2020;9:1531. DOI:10.3389/fonc.2019.01531
4. Klyuchagina Yu.I., Sokolova Z.A., Baryshnikova M.A. Role of PD-1 receptor and its ligands PD-L1 and PD-L2 in cancer immunotherapy. Onkopediatriya = Oncopediatrics 2017;4(1):49–55. (In Russ.). DOI:10.15690/onco.v4i1.1684
5. Haworth K.B., Leddon J.L., Chen C.Y. et al. Going back to class I: MHC and immunotherapies for childhood cancer. Pediatr Blood Cancer 2015;62(4):571–6. DOI:10.1002/pbc.25359
6. Topalian S.L., Drake C.G., Pardoll D.M. Targeting the PD-1/B7H1(PD-L1) pathway to activate anti-tumor immunity. Curr Opin Immunol 2012;24(2):207–12. DOI:10.1016/j.coi.2011.12.009
7. Okazaki T., Honjo T. PD-1 and PD-1 ligands: from discovery to clinical application. Int Immunol 2007;19(7):813–24. DOI:10.1093/intimm/dxm057
8. Nishimura H., Nose M., Hiai H. et al. Development of lupus-like autoimmune diseases by disruption of the PD-1 gene encoding an ITIM motif-carrying immunoreceptor. Immunity 1999;11(2): 141–51. DOI:10.1016/s1074-7613(00)80089-8
9. Good-Jacobson K.L., Szumilas C.G., Chen L. et al. PD-1 regulates germinal center B-cell survival and the formation and affinity of long-lived plasma cells. Nat Immunol 2010;11(6):535–42. DOI:10.1038/ni.1877
10. Nishino M., Giobbie-Hurder A., Hatabu H. et al. Incidence of programmed cell death 1 inhibitor-related pneumonitis in patients with advanced cancer: a systematic review and meta-analysis. JAMA Oncol 2016;2(12):1607–16. DOI:10.1001/jamaoncol.2016.2453
11. Wang Y., Zhou S., Yang F. et al. Treatment-related adverse events of PD-1 and PD-L1 inhibitors in clinical trials: a systematic review and meta-analysis. JAMA Oncol 2019;5(7):1008–19. DOI:10.1001/jamaoncol.2019.0393
12. Denisova E.S., Ardzinba M.S., Laktionov K.K. et al. A case report of immune-related pneumonitis after combined treatment of non small cell lung cancer. Meditsinskiy sovet = Medical Council 2020;(9): 258–64. (In Russ.). DOI:10.21518/2079-701X-2020-9-258-264
13. Naidoo J., Wang X., Woo K.M. et al. Pneumonitis in patients treated with anti-programmed death-1/programmed death ligand 1 therapy [published correction appears in J Clin Oncol 2017;35(22):2590]. J Clin Oncol 2017;35(7):709–17. DOI:10.1200/JCO.2016.68.2005
Review
For citations:
Utesheva K.I., Valiev T.T., Ignatenko O.A., Goryacheva S.V., Batmanova N.A., Kirgizov K.I. A clinical case of immune-mediated pneumonitis after nivolumab in a patient with Burkitt lymphoma. Oncohematology. 2023;18(1):121-125. (In Russ.) https://doi.org/10.17650/1818-8346-2023-18-1-121-125
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