Fatal myocarditis after the first dose of nivolumab.
Fatální myokarditida po první dávce nivolumabu.
cardiotoxicity
checkpoint inhibitors
immune checkpoint inhibitors
immunotherapy
immunotherapy
nivolumab
thymic carcinoma
Journal
Klinicka onkologie : casopis Ceske a Slovenske onkologicke spolecnosti
ISSN: 1802-5307
Titre abrégé: Klin Onkol
Pays: Czech Republic
ID NLM: 9425213
Informations de publication
Date de publication:
2022
2022
Historique:
entrez:
13
12
2022
pubmed:
14
12
2022
medline:
16
12
2022
Statut:
ppublish
Résumé
Thymic carcinoma (TC) is a rare subtype of thymic epithelial malignancy. Surgical resection is a mainstay in the treatment of TC, while radiotherapy and chemotherapy are modalities used in adjuvant or palliative setting. Immune checkpoint inhibitors (ICI) including anti-PD-1 (programmed cell death 1) antibodies represent an emerging treatment modality in TC; however, their administration could be associated with life-threatening toxicity. We present a case of a 59-year-old female with grade III TC, who had received neoadjuvant chemotherapy followed by surgery and subsequent adjuvant radio-immunotherapy with an ICI, nivolumab. We provide our experience with the toxicity of an administered treatment. Fourteen days after the first dose of nivolumab and on 21st day after starting of radiotherapy (total dose of 40 Gy), the patient developed fulminant myocarditis with subsequent heart failure. Despite immunosuppressive therapy with high-dose glucocorticoids and mycophenolate mofetil and intensive support, the patient died within 6 days after the onset of first symptoms. Physicians should be aware of these extremely rare, but potentially fatal complications of immunotherapy.
Sections du résumé
BACKGROUND
BACKGROUND
Thymic carcinoma (TC) is a rare subtype of thymic epithelial malignancy. Surgical resection is a mainstay in the treatment of TC, while radiotherapy and chemotherapy are modalities used in adjuvant or palliative setting. Immune checkpoint inhibitors (ICI) including anti-PD-1 (programmed cell death 1) antibodies represent an emerging treatment modality in TC; however, their administration could be associated with life-threatening toxicity.
CASE
METHODS
We present a case of a 59-year-old female with grade III TC, who had received neoadjuvant chemotherapy followed by surgery and subsequent adjuvant radio-immunotherapy with an ICI, nivolumab. We provide our experience with the toxicity of an administered treatment.
RESULTS
RESULTS
Fourteen days after the first dose of nivolumab and on 21st day after starting of radiotherapy (total dose of 40 Gy), the patient developed fulminant myocarditis with subsequent heart failure. Despite immunosuppressive therapy with high-dose glucocorticoids and mycophenolate mofetil and intensive support, the patient died within 6 days after the onset of first symptoms.
CONCLUSION
CONCLUSIONS
Physicians should be aware of these extremely rare, but potentially fatal complications of immunotherapy.
Identifiants
pubmed: 36513516
pii: 132851
doi: 10.48095/ccko2022486
doi:
Substances chimiques
Nivolumab
31YO63LBSN
Antineoplastic Agents, Immunological
0
Immune Checkpoint Inhibitors
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM