Immune checkpoint inhibitors may cause specific immune-related reactions, such as pseudo-progression. In particular, malignant pleural effusion tends to worsen due to this phenomenon. However, the appropriate management in such cases is unclear. We report a 73-year-old man with advanced lung adenocarcinoma and malignant pleural effusion who developed pseudo-progression with immune-related interstitial lung disease (irILD) induced by pembrolizumab (Merck & Co., Kenilworth, NJ, USA). After managing them with steroid treatments and chemotherapy, pembrolizumab was re-administered. At the time of writing, 30 months have passed since the re-administration of pembrolizumab without disease progression. This clinical course conveys an appropriate management strategy for patients with pseudo-progression and irILD.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8338124PMC
http://dx.doi.org/10.7759/cureus.16177DOI Listing

Publication Analysis

Top Keywords

pseudo-progression immune-related
8
immune-related interstitial
8
interstitial lung
8
lung disease
8
malignant pleural
8
pleural effusion
8
appropriate management
8
long-term survival
4
pembrolizumab
4
survival pembrolizumab
4

Similar Publications

Aim: To determine the long-term prognosis of immune-related response profiles (pseudoprogression and dissociated response), not covered by conventional PERCIST criteria, in patients with non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICPIs).

Methods: 109 patients were prospectively included and underwent [F]FDG-PET/CT at baseline, after 7 weeks (PET1), and 3 months (PET2) of treatment. On PET1, tumor response was assessed using standard PERCIST criteria.

View Article and Find Full Text PDF

Systemic emboli are not uncommon in patients with advanced non-small cell lung cancer. The present study describes a rare case of long-term control in a patient with lung adenocarcinoma, nonbacterial thrombotic endocarditis and multiple systemic emboli. Briefly, a 56-year-old man was diagnosed with metastatic lung adenocarcinoma and was treated with pembrolizumab, which was discontinued due to the appearance of a pulmonary immune-related adverse event.

View Article and Find Full Text PDF

Assessing Radiological Response to Immunotherapy in Lung Cancer: An Evolving Arena.

Cancer Diagn Progn

January 2024

Wolfson Institute of Population Health, Cancer Research UK Barts Centre, Queen Mary University of London, London, U.K.

In the past decade, immune checkpoint inhibitors (ICIs) have entered the treatment landscape of non-small-cell lung cancer, signalling a paradigm shift within the field characterized by significant survival benefits for patients with advanced and metastatic disease, and especially those with non-targetable genetic oncogenic driver mutations. However, the shift towards immune-based treatments has created new challenges in oncology. Atypical immunotherapy response patterns, including pseudo-progression and hyperprogressive disease, as well as immune-related adverse events have generated the need for new methods to predict patient response to treatment.

View Article and Find Full Text PDF
Article Synopsis
  • Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the primary types of nonmelanoma skin cancers, and their occurrence and mortality rates have increased in recent years, posing challenges for treatment, especially for patients with advanced stages of the disease.
  • Improved diagnostic methods that include patient characteristics are essential for better risk assessment, given that those with a history of systemic treatments face higher risks for these cancers.
  • The use of PET/CT scans has shown to be more effective than CT and MRI in detecting metastasis, and while immunotherapy has enhanced treatment responses, it also introduces complexities that require radiologists to stay informed on tumor characteristics and potential adverse effects to optimize patient outcomes.
View Article and Find Full Text PDF

The anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4) monoclonal antibody ipilimumab was the first in-class immune-checkpoint inhibitor (ICI) approved for the treatment of melanoma patients. Initially approved for metastatic cutaneous melanoma, treatment with ipilimumab subsequently demonstrated to significantly improve recurrence free survival (RFS) in fully resected, high-risk, stage III melanoma patients. Therapeutic use of ipilimumab has also allowed the initial identification and characterization of unconventional clinical and radiological patterns of response (ie, tumor flare, pseudo-progression) that may occur during ICI therapy, unlike chemotherapy or targeted therapy.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!