Delayed Onset Immune-Related Pituitary Adrenal Insufficiency Induced by Neoadjuvant Nivolumab Therapy for Locally Advanced Lung Cancer in the Postoperative Period: A Case Report

Article

Author: Ishikawa, Masashi ; Kaneko, Shizuka ; Ikeda, Masaki ; Nomura, Shinnosuke ; Terashita, Satoshi ; Kitahori, Kaito ; Kabuto, Takafumi ; Chiba, Naohisa

INTRODUCTIONNeoadjuvant, adjuvant, and perioperative immune checkpoint inhibitor (ICI) regimens for treating locally advanced lung cancer have dramatically evolved in recent years. Despite these immunotherapies being very promising, they can be associated with potential life-threatening immune-related adverse events (irAEs), and there is not much awareness regarding irAEs in surgical regimens.CASE PRESENTATIONA Japanese man in his 70s was diagnosed with right upper lobe lung adenocarcinoma (cT3N1[#12u]M0, parietal pleural invasion, cStage IIIA), with the programmed death-ligand 1 expression level of <1%. He underwent right upper lobectomy via open thoracotomy followed by 3 cycles of neoadjuvant cisplatin, pemetrexed, and nivolumab. The pathological response rate was 50% and the pathological stage was ypT2bN0M0, ypStage IIA. Seven months after the surgery, he experienced gradually worsening anorexia, fatigue, and hyponatremia. He was diagnosed with pituitary adrenal insufficiency induced by neoadjuvant immunotherapy by the 100 μg corticotropin-releasing hormone stress test. Cardiogenic shock caused by takotsubo cardiomyopathy occurred, and intensive treatment was performed. Steroid therapy was effective, but the physical dysfunction persisted, although no recurrence of lung cancer was observed.CONCLUSIONSPatients receiving neoadjuvant immunotherapies can develop life-threatening irAEs late in the postoperative period. Surgeons who follow up patients after neoadjuvant immunotherapies must be as vigilant regarding the development of irAEs in the postoperative phase as clinical oncologists.

01 Jan 2025·Gan to kagaku ryoho. Cancer & chemotherapy

[A Case of Advanced Gastric Cancer with Massive Lymph Node Metastases Greatly Decreased in Size after Chemotherapy with Nivolumab and SOX].

Article

Author: Nishikawa, Masahiro ; Miyashita, Seikann ; Uenishi, Takahiro ; Kuwae, Yuuko ; Kato, Yukihiro ; Kikukawa, Takuya ; Matsuda, Hanae ; Isihara, Atsushi ; Osawa, Masahiko ; Morita, Ruiichiro ; Matsuda, Yasunori

A 81-year-old woman was referred to our department for further examination and treatment after upper gastrointestinal endoscopy revealed a type 3 tumor in the antrum. CT scan revealed a primary tumor with extramural invasion in the antrum and large lymph nodes bordering the pancreas, as well as in the right side of cardia. A diagnosis of advanced gastric cancer cT4aN2M0, cStage Ⅲ was made. She was administered chemotherapy with nivolumab and SOX. After 2 courses of treatment, CT scan showed marked reduction of the primary tumor and lymph nodes. Therefore, laparoscopic gastrectomy(D2 dissection+Roux-en-Y reconstruction)was performed. Histopathological findings showed that the primary tumor was confined to the sub serosal tissue and no lymph node metastases were observed. The patient is currently alive without recurrence and treated with S-1 monotherapy. Chemotherapy with nivolumab and SOX is considered to be an effective treatment strategy for advanced gastric cancer with advanced lymph node metastases.

01 Jan 2025·Archivos Españoles de Urología

Letter to the Editor Re: Research Progress and Efficacy Evaluation of Nivolumab in the Treatment of Metastatic Renal Cancer

Letter

Author: Liu, Shenfang ; Jiang, Xinyu ; Liu, Lihua ; Zhao, Fang ; Dong, Xing

100 Deals associated with Nivolumab Biosimilar (Rophibio)

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Indication	Highest Phase	Country/Location	Organization	Date
Neoplasms	Preclinical	South Korea	Rophibio Co., Ltd	09 Aug 2023

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