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Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC

The safety of neoadjuvant chemoimmunotherapy before surgery in patients with non–small cell lung cancer (NSCLC) remains unclear in the perioperative stage. We describe a case of a 63‐year‐old man with IIIC stage NSCLC who received neoadjuvant chemoimmunotherapy and radical lobectomy. After the secon...

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Autores principales: Xu, Yuan, Lyu, Xiaohong, Qin, Yingzhi, Ma, Dongjie, Wang, Mengzhao, Shi, Juhong, Long, Yun, Tang, Bo, Liu, Hongsheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376172/
https://www.ncbi.nlm.nih.gov/pubmed/35815431
http://dx.doi.org/10.1111/1759-7714.14567
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author Xu, Yuan
Lyu, Xiaohong
Qin, Yingzhi
Ma, Dongjie
Wang, Mengzhao
Shi, Juhong
Long, Yun
Tang, Bo
Liu, Hongsheng
author_facet Xu, Yuan
Lyu, Xiaohong
Qin, Yingzhi
Ma, Dongjie
Wang, Mengzhao
Shi, Juhong
Long, Yun
Tang, Bo
Liu, Hongsheng
author_sort Xu, Yuan
collection PubMed
description The safety of neoadjuvant chemoimmunotherapy before surgery in patients with non–small cell lung cancer (NSCLC) remains unclear in the perioperative stage. We describe a case of a 63‐year‐old man with IIIC stage NSCLC who received neoadjuvant chemoimmunotherapy and radical lobectomy. After the second cycle of pembrolizumab and chemotherapy (paclitaxel + carboplatin), the patient was diagnosed with immunologic enterocolitis and relieved by glucocorticoid therapy. Radical lobectomy of the right upper lobe was then performed. On postoperative day 4 (POD 4), the patient suddenly suffered suffocated wheezing during sleep. Interstitial lung disease was, therefore, identified by chest computed tomography scan. Glucocorticoids and mechanical ventilation were applied and the symptoms were relieved. On POD 10, the patient developed a bronchial fistula and underwent emergent repair surgery. This is the first case of multi‐organs, multi‐time point immune‐related adverse events (irAE) in perioperative NSCLC patients who received neoadjuvant chemoimmunotherapy. Clinicians should be on high alert for signs of irAEs in neoadjuvant chemoimmunotherapy patients, promptly requiring multidisciplinary management.
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spelling pubmed-93761722022-08-18 Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC Xu, Yuan Lyu, Xiaohong Qin, Yingzhi Ma, Dongjie Wang, Mengzhao Shi, Juhong Long, Yun Tang, Bo Liu, Hongsheng Thorac Cancer Original Articles The safety of neoadjuvant chemoimmunotherapy before surgery in patients with non–small cell lung cancer (NSCLC) remains unclear in the perioperative stage. We describe a case of a 63‐year‐old man with IIIC stage NSCLC who received neoadjuvant chemoimmunotherapy and radical lobectomy. After the second cycle of pembrolizumab and chemotherapy (paclitaxel + carboplatin), the patient was diagnosed with immunologic enterocolitis and relieved by glucocorticoid therapy. Radical lobectomy of the right upper lobe was then performed. On postoperative day 4 (POD 4), the patient suddenly suffered suffocated wheezing during sleep. Interstitial lung disease was, therefore, identified by chest computed tomography scan. Glucocorticoids and mechanical ventilation were applied and the symptoms were relieved. On POD 10, the patient developed a bronchial fistula and underwent emergent repair surgery. This is the first case of multi‐organs, multi‐time point immune‐related adverse events (irAE) in perioperative NSCLC patients who received neoadjuvant chemoimmunotherapy. Clinicians should be on high alert for signs of irAEs in neoadjuvant chemoimmunotherapy patients, promptly requiring multidisciplinary management. John Wiley & Sons Australia, Ltd 2022-07-11 2022-08 /pmc/articles/PMC9376172/ /pubmed/35815431 http://dx.doi.org/10.1111/1759-7714.14567 Text en © 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://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 Original Articles
Xu, Yuan
Lyu, Xiaohong
Qin, Yingzhi
Ma, Dongjie
Wang, Mengzhao
Shi, Juhong
Long, Yun
Tang, Bo
Liu, Hongsheng
Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC
title Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC
title_full Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC
title_fullStr Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC
title_full_unstemmed Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC
title_short Multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with NSCLC
title_sort multi‐organs perioperative immune‐related adverse events and postoperative bronchial anastomotic fistula in a patient receiving neoadjuvant immunotherapy with nsclc
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376172/
https://www.ncbi.nlm.nih.gov/pubmed/35815431
http://dx.doi.org/10.1111/1759-7714.14567
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