Tuberculosis Reactivation in a Patient Treated With Nivolumab for Non-small Cell Lung Cancer: A Case Report
Publication Date : 21/11/2022
The antibody against programmed cell-death nivolumab and other immune checkpoint inhibitors are used to promote reactivation of anti-tumor immunity in the fight against cancer. Data from case reports recently raised the question of a particular immune-related adverse event: secondary pulmonary tuberculosis as a consequence of excessive reactivation of the immune responsiveness to latent Mycobacterium tuberculosis infection. This case report describes a 67-year old Caucasian male who presented with reactivation of tuberculosis infection of the pleura and pericardium while on nivolumab therapy for non-small cell lung cancer. He received antituberculous treatment, with favorable evolution. With no available guidelines for the management of tuberculosis during PD-1/PD-L1 blockade, a high index of suspicion should be considered when the evolution of the patient is not respecting the expected pattern. This approach should be applied especially in countries with a high burden of tuberculosis.
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