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Two Cases of Nivolumab Re-Administration after Pneumonitis as Immune-Related Adverse Events

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Title: Two Cases of Nivolumab Re-Administration after Pneumonitis as Immune-Related Adverse Events
Authors: Imafuku, Keisuke Browse this author
Yoshino, Koji Browse this author
Yamaguchi, Kei Browse this author
Tsuboi, Satoshi Browse this author
Ohara, Kuniaki Browse this author
Hata, Hiroo Browse this author →KAKEN DB
Keywords: Nivolumab
Immune-related adverse event
Re-administration
Unresectable malignant melanoma
Cryptogenic organizing pneumonia
Diffuse alveolar damage
Pneumonitis
Issue Date: Apr-2017
Publisher: Karger
Journal Title: Case Reports in Oncology
Volume: 10
Issue: 1
Start Page: 296
End Page: 300
Publisher DOI: 10.1159/000463379
PMID: 28512413
Abstract: Nivolumab is a recently approved medication for the treatment of unresectable malignant melanoma. Many immune-related adverse events (irAEs) associated with nivolumab have been reported, such as pneumonitis, hepatitis, dermatitis, and thyroiditis. Prednisolone can effectively treat irAEs. However, it is unclear how or if nivolumab should be administered to patients after they have experienced an irAE. Herein, we show 2 patients who underwent pneumonitis as irAE. Case 1 demonstrated a cryptogenic organizing pneumonia pattern in the CT scan and case 2 had a diffuse alveolar damage (DAD) pattern. Oral corticosteroids improved chest shadow of CT scan in both cases. However, when nivolumab was re-administrated, case 1 demonstrated no symptoms, but case 2 demonstrated pneumonia again. From our cases, it is difficult to re-administrate nivolumab for the patients with pneumonitis which shows a DAD pattern in CT, even if oral corticosteroids improve their symptoms.
Rights: The final, published version of this article is available at http://www.karger.com/?doi=10.1159/000463379
https://creativecommons.org/licenses/by-nc/4.0/
Type: article
URI: http://hdl.handle.net/2115/67613
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 秦 洋郎

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