Acute-Onset Pneumonitis while Administering the First Dose of Durvalumab

In locally advanced non-small cell lung cancer (NSCLC) patients, consolidation therapy with durvalumab (an anti-PD-L1 monoclonal antibody) has proven to significantly increase both progression free and overall survival after chemoradiotherapy. Here, we describe a case of acute pneumonitis during durvalumab administration for locally advanced NSCLC, causing persistent symptomatology and steroid treatment to date. To our knowledge, acute-onset pneumonitis during infusion of a PD-L1 inhibitor has not been described previously. This case illustrates that ICI-induced pneumonitis can occur anytime during treatment, especially after chemoradiation.

[1]  Xin Wang,et al.  Treatment-Related Adverse Events of PD-1 and PD-L1 Inhibitors in Clinical Trials: A Systematic Review and Meta-analysis. , 2019, JAMA oncology.

[2]  D. Planchard,et al.  Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC , 2018, The New England journal of medicine.

[3]  W. Shi,et al.  Safety of combining thoracic radiation therapy with concurrent versus sequential immune checkpoint inhibition , 2018, Advances in radiation oncology.

[4]  A. Benson,et al.  An Extremely Rapid Case of Pneumonitis with the Use of Nivolumab for Pancreatic Adenocarcinoma , 2018, Case reports in oncological medicine.

[5]  M. Akira,et al.  Severe acute interstitial lung disease after nivolumab in three non-small cell lung cancer patients with imaging findings of airway obstruction adjacent to lung tumors. , 2017, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy.

[6]  P. Mazzone,et al.  Incidence of Pneumonitis With Use of Programmed Death 1 and Programmed Death‐Ligand 1 Inhibitors in Non‐Small Cell Lung Cancer: A Systematic Review and Meta‐Analysis of Trials , 2017, Chest.

[7]  C. Rudin,et al.  Pneumonitis in Patients Treated With Anti-Programmed Death-1/Programmed Death Ligand 1 Therapy. , 2017, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  V. Sondak,et al.  Adjuvant immunotherapy for cancer: the next step. , 2015, The Lancet. Oncology.

[9]  Loise M. Francisco,et al.  RGMb is a novel binding partner for PD-L2 and its engagement with PD-L2 promotes respiratory tolerance , 2014, The Journal of experimental medicine.

[10]  Keunchil Park,et al.  Durvalumab as third-line or later treatment for advanced non-small-cell lung cancer (ATLANTIC): an open-label, single-arm, phase 2 study. , 2018, The Lancet. Oncology.