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Vol.60 No.7 contents | Japanese/English |
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- Case Report -
A Case of Concurrent Lung Cancer Recurrence and Pembrolizumab-induced Lung Injury After a Long-term Response to Pembrolizumab
Hideto Oshita1, Tatsuki Takahashi1, Misato Senoo1, Kunihiko Funaishi1, Yasuyuki Mitama1, Ken Okusaki11Department of Internal Medicine, Mihara Medical Association Hospital, Japan
Background. A long-term clinical response is sometimes seen in patients with lung cancer treated with immune checkpoint inhibitors. However, immune-related adverse events, such as drug-induced lung injury, may also occur in the long run. Case. A 71-year-old man had been administered pembrolizumab for lung adenocarcinoma for the past 2 years, and his lung cancer had almost disappeared. However, chest computed tomography revealed new infiltrative shadows in the upper and lower lobes of the left lung. Furthermore, adenocarcinoma cells were detected in specimens collected by bronchoscopy from the upper lobe lesions. Because of the rapid expansion of the infiltrates after pembrolizumab withdrawal, corticosteroid therapy was initiated, which led to the disappearance of nearly all of the infiltrates except for a nodule in the left upper lobe. The patient was therefore diagnosed with recurrent lung cancer coexisting with delayed pembrolizumab-induced lung injury. Conclusion. In some cases, it is difficult to distinguish between recurrent lung cancer and drug-induced lung injury based solely on imaging findings; a pathological examination of specimens obtained by bronchoscopy and the response to steroids should therefore also be considered when making a diagnosis.
key words: Drug-induced lung injury, Immune checkpoint inhibitor (ICI), Pembrolizumab
Received: August 1, 2020
Accepted: September 4, 2020
JJLC 60 (7): 1007-1011, 2020
