PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性

BACKGROUND AND OBJECTIVE: Immune checkpoint inhibitor associated pneumonia (CIP) is a serious side effect of immune checkpoint inhibitors. There is a consensus on the treatment of acute phase of CIP, but the treatment of pulmonary interstitial fibrosis after the acute phase is still a clinical probl...

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Formato: Online Artículo Texto
Lenguaje:English
Publicado: 中国肺癌杂志编辑部 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317093/
https://www.ncbi.nlm.nih.gov/pubmed/34134189
http://dx.doi.org/10.3779/j.issn.1009-3419.2021.103.08
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description BACKGROUND AND OBJECTIVE: Immune checkpoint inhibitor associated pneumonia (CIP) is a serious side effect of immune checkpoint inhibitors. There is a consensus on the treatment of acute phase of CIP, but the treatment of pulmonary interstitial fibrosis after the acute phase is still a clinical problem to be solved. METHODS: The diagnosis and treatment of a non-small cell lung cancer (NSCLC) patient with immune checkpoint inhibitor associated pneumonia in the Stereotactic Radiotherapy Department of Qingdao Central Hospital were retrospectively analyzed, and literatures were reviewed. RESULTS: A 70-year-old male patient was diagnosed with Poorly differentiated squamous cell carcinoma of left lung with mediastinal lymph node metastasis T3N3M0 stage Ⅲc, EGFR/ALK/ROS1/RAF negative, PD-L1 (22c3) immunohistochemistry negative. After the progression of first-line chemotherapy, the patient was diagnosed as immune checkpoint inhibitor associated pneumonia grade 3 during second-line monotherapy with Nivolumab. After initial high-dose glucocorticoid pulse therapy, the lung computed tomography (CT) imaging and clinical symptoms of the patients were partially relieved, and then pirfenidone (300 mg tid) was given orally for more than 11 months. During the treatment of pirfenidone, the CT imaging and clinical symptoms of the patients were significantly improved, and there were no other adverse reactions except grade 1 nausea. During this period, chemotherapy and Anlotinib was given concurrently with pirfenidone and showed good safety profile. CONCLUSION: This case report is the first report of pirfenidone in the treatment of CIP, which provides a new idea for the clinical practice and research of CIP treatment.
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spelling pubmed-83170932021-08-12 PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性 Zhongguo Fei Ai Za Zhi 病例报道 BACKGROUND AND OBJECTIVE: Immune checkpoint inhibitor associated pneumonia (CIP) is a serious side effect of immune checkpoint inhibitors. There is a consensus on the treatment of acute phase of CIP, but the treatment of pulmonary interstitial fibrosis after the acute phase is still a clinical problem to be solved. METHODS: The diagnosis and treatment of a non-small cell lung cancer (NSCLC) patient with immune checkpoint inhibitor associated pneumonia in the Stereotactic Radiotherapy Department of Qingdao Central Hospital were retrospectively analyzed, and literatures were reviewed. RESULTS: A 70-year-old male patient was diagnosed with Poorly differentiated squamous cell carcinoma of left lung with mediastinal lymph node metastasis T3N3M0 stage Ⅲc, EGFR/ALK/ROS1/RAF negative, PD-L1 (22c3) immunohistochemistry negative. After the progression of first-line chemotherapy, the patient was diagnosed as immune checkpoint inhibitor associated pneumonia grade 3 during second-line monotherapy with Nivolumab. After initial high-dose glucocorticoid pulse therapy, the lung computed tomography (CT) imaging and clinical symptoms of the patients were partially relieved, and then pirfenidone (300 mg tid) was given orally for more than 11 months. During the treatment of pirfenidone, the CT imaging and clinical symptoms of the patients were significantly improved, and there were no other adverse reactions except grade 1 nausea. During this period, chemotherapy and Anlotinib was given concurrently with pirfenidone and showed good safety profile. CONCLUSION: This case report is the first report of pirfenidone in the treatment of CIP, which provides a new idea for the clinical practice and research of CIP treatment. 中国肺癌杂志编辑部 2021-07-20 /pmc/articles/PMC8317093/ /pubmed/34134189 http://dx.doi.org/10.3779/j.issn.1009-3419.2021.103.08 Text en 版权所有©《中国肺癌杂志》编辑部2021 https://creativecommons.org/licenses/by/3.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) License. See: https://creativecommons.org/licenses/by/3.0/.
spellingShingle 病例报道
PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性
title PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性
title_full PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性
title_fullStr PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性
title_full_unstemmed PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性
title_short PD-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性
title_sort pd-1单抗导致免疫检查点抑制剂相关肺炎1例——吡非尼酮治疗的安全性和有效性
topic 病例报道
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317093/
https://www.ncbi.nlm.nih.gov/pubmed/34134189
http://dx.doi.org/10.3779/j.issn.1009-3419.2021.103.08
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