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Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports
INTRODUCTION: In development of novel therapies for the treatment of patient with cancer, the use of radiotherapy (RT) can produce significant local control and, in recent studies, has also been shown to mediate anti-tumor responses at distant sites by triggering and enhancing the endogenous cellula...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228676/ https://www.ncbi.nlm.nih.gov/pubmed/28072716 http://dx.doi.org/10.1097/MD.0000000000005747 |
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author | Lu, Chieh-Sheng Liu, Jin-Hwang |
author_facet | Lu, Chieh-Sheng Liu, Jin-Hwang |
author_sort | Lu, Chieh-Sheng |
collection | PubMed |
description | INTRODUCTION: In development of novel therapies for the treatment of patient with cancer, the use of radiotherapy (RT) can produce significant local control and, in recent studies, has also been shown to mediate anti-tumor responses at distant sites by triggering and enhancing the endogenous cellular immune responses. Although RT induces an abscopal effect in some patients due to enhanced immune response to the tumor, immune-escape mechanisms, including up-regulation of programmed death-ligand 1 (PD-L1) on tumor cells, limit this benefit in other patients. Hence, many studies have promoted the synergy of RT and anti-programmed cell death protein 1 (PD-1) treatment for antitumor immunity. However, outcome may be improved when more therapies are combined, but risk of side effects can be increased. CASE PRESENTATION: We herein present 3 advanced cancer patients with pulmonary metastasis and who received RT. Later, they underwent anti-PD-1 treatment and unfortunately suffered from anti-PD-1-related pneumonitis over the nonirradiated areas after 4 cycles of treatment. The upregulation of cellular PD-1 expression in these areas was considered and the immune overreaction by anti-PD-1 treatment may cause these severe pulmonary adverse effects. CONCLUSION: Our review of 3 cases warrants careful workup to reduce the risk of side effects by combinative therapy with RT and anti-PD-1 treatment. |
format | Online Article Text |
id | pubmed-5228676 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-52286762017-01-25 Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports Lu, Chieh-Sheng Liu, Jin-Hwang Medicine (Baltimore) 5700 INTRODUCTION: In development of novel therapies for the treatment of patient with cancer, the use of radiotherapy (RT) can produce significant local control and, in recent studies, has also been shown to mediate anti-tumor responses at distant sites by triggering and enhancing the endogenous cellular immune responses. Although RT induces an abscopal effect in some patients due to enhanced immune response to the tumor, immune-escape mechanisms, including up-regulation of programmed death-ligand 1 (PD-L1) on tumor cells, limit this benefit in other patients. Hence, many studies have promoted the synergy of RT and anti-programmed cell death protein 1 (PD-1) treatment for antitumor immunity. However, outcome may be improved when more therapies are combined, but risk of side effects can be increased. CASE PRESENTATION: We herein present 3 advanced cancer patients with pulmonary metastasis and who received RT. Later, they underwent anti-PD-1 treatment and unfortunately suffered from anti-PD-1-related pneumonitis over the nonirradiated areas after 4 cycles of treatment. The upregulation of cellular PD-1 expression in these areas was considered and the immune overreaction by anti-PD-1 treatment may cause these severe pulmonary adverse effects. CONCLUSION: Our review of 3 cases warrants careful workup to reduce the risk of side effects by combinative therapy with RT and anti-PD-1 treatment. Wolters Kluwer Health 2017-01-10 /pmc/articles/PMC5228676/ /pubmed/28072716 http://dx.doi.org/10.1097/MD.0000000000005747 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-sa/4.0 This is an open access article distributed under the Creative Commons Attribution-Share Alike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-sa/4.0 |
spellingShingle | 5700 Lu, Chieh-Sheng Liu, Jin-Hwang Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports |
title | Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports |
title_full | Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports |
title_fullStr | Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports |
title_full_unstemmed | Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports |
title_short | Pneumonitis in cancer patients receiving anti-PD-1 and radiotherapies: Three case reports |
title_sort | pneumonitis in cancer patients receiving anti-pd-1 and radiotherapies: three case reports |
topic | 5700 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228676/ https://www.ncbi.nlm.nih.gov/pubmed/28072716 http://dx.doi.org/10.1097/MD.0000000000005747 |
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