Immune-checkpoint inhibitors for lung cancer patients amid the COVID-19 pandemic : a case report of severe meningoencephalitis after switching to an extended-interval higher flat-dose nivolumab regimen
Pous, Anna (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Izquierdo, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cucurull, Marc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sánchez, Silvia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Lezcano, Clara (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domènech, Marta (Badalona Applied Research Group in Oncology)
Llobera, Laia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Plaja, Andrea (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Morán, Teresa (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2021
Resum:	Alternative dosage regimens for some anticancer therapies have been proposed in the midst of the SARS-COV-2 pandemic in order to protect the patients from attending to health care facilities. Flat-dosing of several immune-checkpoint inhibitors (ICIs), including nivolumab, have been established. Although generally well tolerated with no new safety signals, new dosages can associate novel individual toxicities. As the use of ICIs is increasing in cancer patients, the present case report is a reminder for clinicians of potential novel toxicities, as well as the need for an interdisciplinary approach for their recognition and treatment. We report the occurrence of a severe neurologic toxicity in a patient with non-small cell lung cancer (NSCLC) who developed should be changed to which occurred after two doses of extended higher interval flat-dose nivolumab despite two years of clinical stability on prior nivolumab regimen. Patient developed fever, language impairment and altered mental status. The work-up tests excluded other potential causes and the most likely diagnosis was meningoencephalitis. Fortunately, with medical treatment, which consisted of high dose steroids, the patient recovered to his baseline situation and symptoms did not recurred, even though nivolumab was resumed. Alternate ICI regimens may have unique immune-related adverse event profiles.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Extended-interval higher flat-dose ; Nivolumab ; Meningoencephalitis ; Non-small cell lung cancer (NSCLC) ; Case report
Publicat a:	Translational Lung Cancer Research, Vol. 10 (april 2021) , p. 1917-1923, ISSN 2226-4477

DOI: 10.21037/tlcr-20-1315
PMID: 34012801

7 p, 718.6 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats