Lack of Reactivation of Latent Tuberculosis Despite PD-1 Immunotherapy and Chemotherapy: A Case Report and Systematic Review

Yang X, Xian XH, Zhu Q and Wang K

Department of Abdominal Oncology, Cancer Center, West China Hospital, Sichuan University, China
Department of Respiratory Medicine, Lung Cancer Center, West China Hospital, Sichuan University, China

^*Correspondance to: Ke Wang 

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Abstract:

Background: Programmed Death 1 (PD-1) has a controversial role in the treatment of Tuberculosis (TB). Several clinical cases of TB development have been reported by administration of anti–PD-1 antibodies for patients with advanced unresectable cancers. Case Report: In this article, we report an interesting case about a male patient with history of cured pulmonary tuberculosis and a 4-month history of repeated hemoptysis. Imaging showed one mass in the lower lobe of left lung and the other in the left upper lobe. The diagnosis of Non-Small-Cell Lung Cancer (NSCLC) was determined by biopsy specimens in the lower lobe nodule and cured pulmonary tuberculosis determined by past medical history. He was given neoadjuvant treatment with an anti–PD-1 inhibitor and chemotherapy. He underwent surgery. Pathological examination revealed Mtb in left upper lobe nodule but previous imaging showed without reactivation and slight reduction in tubercular infection inflammation. The left lower lobe nodule was poorly differentiated carcinoma. Conclusion: Overall, the role of immune checkpoint inhibitors in patients with cancers and latent tuberculosis infection is inconclusive. Although we cannot establish whether patients with stage IIIA NSCLC and concurrent latent pulmonary tuberculosis after surgical evaluation can receive a PD-1 and chemotherapy as neoadjuvant therapy without the activation of pulmonary tuberculosis, our case endorses the need of further evaluation.

Keywords:

NSCLC; PD-1 inhibitors; Reactivation; Mtb

Cite the Article:

Yang X, Xian XH, Zhu Q, Wang K. Lack of Reactivation of Latent Tuberculosis Despite PD-1 Immunotherapy and Chemotherapy: A Case Report and Systematic Review. Clin Oncol. 2023;8:2026..