Effects and Side Effects of Nivolumab: From Pneumonitis to Complete Remission Complete Response of Metastatic NSCLC after Resolution of a Pneumonitis on Nivolumab Treatment

Alexander R Siebenhüner, Bart Vrugt and Alessandra Curioni-Fontecedro

Department of Oncology, University Hospital Zurich, Switzerland
Department of Surgical Pathology, University Hospital Zurich, Switzerland

^*Correspondance to: Alexander R Siebenh�ner 

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Abstract:

Non-Small Cell Lung Cancer (NSCLC) without driver mutations has limited the rapeutic options beyond first line chemo therapy. A 62-year-old patient was diagnosed with adenosquamous lung cancer, with initial oligometastatic stage IV disease and no driver mutations. After initial treatment with3 cycles of cisplatin-gemcitabine tumor progression with bone lesions was detected. On immunohistochemistry, the tumor showed a strong (over 50%) expression of PD-L1 on the membrane of tumor cells and treatment with nivolumab was given to the patient. Within two courses of nivolumab the clinical symptoms of acute dyspnea and cough occurred. The diagnosis of nivolumab related pneumonitis was found and the patient received treatment with high dose steroids and antibiotics. A PET-CT scan 12 weeks after the onset of the pneumonitis showed a complete remission of pneumonic infiltrates as well as further response of the bone lesions. Oncological decisions of further treatment included radiological and clinical follow-up without any further treatment with nivolumab. To date, 15months after the last treatment with nivolumab, the patient is still in complete remission. Nivolumab is the new standard of treatment in second line for NSCLC since the approval of FDA and EMA. This case shows not only how to manage an immune response related pneumonitis. In addition the case showed an exceptional response of this tumor to only two courses of nivolumab.

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Cite the Article:

Siebenhüner AR, Vrugt B, Curioni- Fontecedro A. Effects and Side Effects of Nivolumab: From Pneumonitis to Complete Remission Complete Response of Metastatic NSCLC after Resolution of A Pneumonitis on Nivolumab Treatment. Clin Oncol. 2017; 2: 1270.