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Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab

A 65‐year‐old man with chronic progressive pulmonary aspergillosis (CPPA) was admitted for the treatment of lung adenocarcinoma while receiving an immune checkpoint inhibitor, nivolumab. The tumour responded well to the therapy, but the cavity of CPPA became large in contrast to the tumour after 20...

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Detalles Bibliográficos
Autores principales: Uchida, Naohiro, Fujita, Kohei, Nakatani, Koichi, Mio, Tadashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756713/
https://www.ncbi.nlm.nih.gov/pubmed/29321933
http://dx.doi.org/10.1002/rcr2.289
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author Uchida, Naohiro
Fujita, Kohei
Nakatani, Koichi
Mio, Tadashi
author_facet Uchida, Naohiro
Fujita, Kohei
Nakatani, Koichi
Mio, Tadashi
author_sort Uchida, Naohiro
collection PubMed
description A 65‐year‐old man with chronic progressive pulmonary aspergillosis (CPPA) was admitted for the treatment of lung adenocarcinoma while receiving an immune checkpoint inhibitor, nivolumab. The tumour responded well to the therapy, but the cavity of CPPA became large in contrast to the tumour after 20 courses of therapy. He was diagnosed as having exacerbation of CPPA and successfully and concurrently treated with an antifungal agent and nivolumab. Since there was absence of obvious immunosuppression and the presence of a drastic effect on tumour remission during nivolumab therapy, this phenomenon suggested that the trigger of CPPA progression was dependent not on immunosuppression but on a hyperreaction to microorganisms, which was similar to the immune reconstitution inflammatory syndrome caused by nivolumab. This was a thought‐provoking case in which the immune checkpoint inhibitor had a paradoxical effect for the tumour and infection.
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spelling pubmed-57567132018-01-10 Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab Uchida, Naohiro Fujita, Kohei Nakatani, Koichi Mio, Tadashi Respirol Case Rep Case Reports A 65‐year‐old man with chronic progressive pulmonary aspergillosis (CPPA) was admitted for the treatment of lung adenocarcinoma while receiving an immune checkpoint inhibitor, nivolumab. The tumour responded well to the therapy, but the cavity of CPPA became large in contrast to the tumour after 20 courses of therapy. He was diagnosed as having exacerbation of CPPA and successfully and concurrently treated with an antifungal agent and nivolumab. Since there was absence of obvious immunosuppression and the presence of a drastic effect on tumour remission during nivolumab therapy, this phenomenon suggested that the trigger of CPPA progression was dependent not on immunosuppression but on a hyperreaction to microorganisms, which was similar to the immune reconstitution inflammatory syndrome caused by nivolumab. This was a thought‐provoking case in which the immune checkpoint inhibitor had a paradoxical effect for the tumour and infection. John Wiley & Sons, Ltd 2017-12-22 /pmc/articles/PMC5756713/ /pubmed/29321933 http://dx.doi.org/10.1002/rcr2.289 Text en © 2017 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Case Reports
Uchida, Naohiro
Fujita, Kohei
Nakatani, Koichi
Mio, Tadashi
Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab
title Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab
title_full Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab
title_fullStr Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab
title_full_unstemmed Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab
title_short Acute progression of aspergillosis in a patient with lung cancer receiving nivolumab
title_sort acute progression of aspergillosis in a patient with lung cancer receiving nivolumab
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756713/
https://www.ncbi.nlm.nih.gov/pubmed/29321933
http://dx.doi.org/10.1002/rcr2.289
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