Particular findings on lung CT in patients undergoing immunotherapy for bronchogenic carcinoma.
Nivolumab
Non-small cell lung cancer
Oncology
PD1 receptor
Radiology
Journal
Wiener klinische Wochenschrift
ISSN: 1613-7671
Titre abrégé: Wien Klin Wochenschr
Pays: Austria
ID NLM: 21620870R
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
13
07
2019
accepted:
29
04
2020
pubmed:
21
5
2020
medline:
18
11
2020
entrez:
21
5
2020
Statut:
ppublish
Résumé
Immune checkpoint inhibitors have become a valuable tool in the therapeutic strategy against metastasized non-small cell lung cancer (NSCLC) as they represent an effective and safe treatment option for many patients; however, the treatment response and side effects of this class of drugs can considerably differ compared to classical chemotherapeutics. The aim of this study was to highlight specific radiological pulmonary findings of NSCLC patients treated with immune checkpoint inhibitors. Medical records and images of prospectively collected data from 70 patients with advanced NSCLC, treated with immune checkpoint inhibitors, were reviewed. Of the patients two experienced an initial increase in tumor size, followed by a decrease in tumor size that was described as pseudoprogression. Another patient developed a sarcoid-like reaction accompanied by clinical improvements and radiological treatment response. A further two patients developed immune checkpoint-associated pulmonary injury that was clinically and radiologically classified as pneumonitis, which responded well to anti-inflammatory treatment. Management of patients with NSCLC using immune checkpoint inhibitors requires a knowledge of specific clinical and radiological findings. Both oncologists and radiologists have to be aware of the most common types, including atypical response patterns, such as a sarcoid-like reaction and pseudoprogression as well as of the pulmonary side effects that can encompass pneumonitis.
Sections du résumé
BACKGROUND
BACKGROUND
Immune checkpoint inhibitors have become a valuable tool in the therapeutic strategy against metastasized non-small cell lung cancer (NSCLC) as they represent an effective and safe treatment option for many patients; however, the treatment response and side effects of this class of drugs can considerably differ compared to classical chemotherapeutics. The aim of this study was to highlight specific radiological pulmonary findings of NSCLC patients treated with immune checkpoint inhibitors.
METHODS AND RESULTS
RESULTS
Medical records and images of prospectively collected data from 70 patients with advanced NSCLC, treated with immune checkpoint inhibitors, were reviewed. Of the patients two experienced an initial increase in tumor size, followed by a decrease in tumor size that was described as pseudoprogression. Another patient developed a sarcoid-like reaction accompanied by clinical improvements and radiological treatment response. A further two patients developed immune checkpoint-associated pulmonary injury that was clinically and radiologically classified as pneumonitis, which responded well to anti-inflammatory treatment.
CONCLUSION
CONCLUSIONS
Management of patients with NSCLC using immune checkpoint inhibitors requires a knowledge of specific clinical and radiological findings. Both oncologists and radiologists have to be aware of the most common types, including atypical response patterns, such as a sarcoid-like reaction and pseudoprogression as well as of the pulmonary side effects that can encompass pneumonitis.
Identifiants
pubmed: 32430613
doi: 10.1007/s00508-020-01667-0
pii: 10.1007/s00508-020-01667-0
pmc: PMC7445205
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
467-474Références
J Cancer Res Clin Oncol. 2018 Oct;144(10):1851-1859
pubmed: 30019319
Eur J Cancer. 2009 Jan;45(2):228-47
pubmed: 19097774
N Engl J Med. 2018 May 24;378(21):1976-1986
pubmed: 29658848
J Thorac Oncol. 2018 Jul;13(7):978-986
pubmed: 29738824
Radiologe. 2017 Oct;57(10):826-833
pubmed: 28812098
J Thorac Oncol. 2019 Mar;14(3):468-474
pubmed: 30468872
Wien Klin Wochenschr. 2018 Feb;130(3-4):85-91
pubmed: 29098404
N Engl J Med. 2015 Jul 9;373(2):123-35
pubmed: 26028407
Memo. 2018;11(2):138-143
pubmed: 29983829
Rofo. 2018 Dec;190(12):1161-1163
pubmed: 30180263
Nat Rev Clin Oncol. 2017 Nov;14(11):655-668
pubmed: 28653677
N Engl J Med. 2015 Oct 22;373(17):1627-39
pubmed: 26412456
Clin Cancer Res. 2017 Oct 1;23(19):5737-5744
pubmed: 28679767
Clin Nucl Med. 2019 Jul;44(7):535-543
pubmed: 31021918
J Immunother Cancer. 2018 Feb 12;6(1):14
pubmed: 29433571
Clin Cancer Res. 2009 Dec 1;15(23):7412-20
pubmed: 19934295
JAMA Oncol. 2018 May 1;4(5):717-721
pubmed: 29423503
Lancet Oncol. 2017 Mar;18(3):e143-e152
pubmed: 28271869
Semin Oncol. 2017 Feb;44(1):3-7
pubmed: 28395760
J Thorac Oncol. 2018 Jan;13(1):106-111
pubmed: 29101058
Lancet Oncol. 2018 Jun;19(6):e327
pubmed: 29893264