Development of pulmonary tuberculosis following treatment with anti-PD-1 for non-small cell lung cancer

Jensen, K.; Persson, G.; Bondgaard, Anna-Louise; Pøhl, Mette

doi:10.1080/0284186x.2018.1433877

Cited by 33 publications

(24 citation statements)

References 5 publications

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“…To our knowledge, there have only been seven reports about acute Tbc infections or reactivations in patients receiving ICI treatment . In this study, Three patients were newly diagnosed with pulmonary Tbc during their anti‐PD‐1 treatment.…”

Section: Discussionmentioning

confidence: 91%

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PD‐1 inhibitors for non‐small cell lung cancer patients with special issues: Real‐world evidence

et al. 2020

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Background Immune checkpoint inhibitors (ICIs) have provided new therapeutic options for non‐small cell lung cancer(NSCLC) patients. However, due to concerning increases in immune‐related adverse events, clinical trials usually exclude patients with special issues such as viral hepatitis, tuberculosis (Tbc), interstitial lung disease (ILD) and autoimmune disease. Methods We retrospectively reviewed the medical records of NSCLC patients who received ICIs, and analyzed the clinical outcomes of patients with special issues. Results Between January 2015 and October 2018, 237 patients received ICIs. Of these patients, 26% (61/237) had special issues: 32 had hepatitis B viral (HBV) infections, 20 Tbc, six ILD, one HIV infection, one Behçet's disease and a past HBV infection, and one rheumatoid arthritis. The incidence of hepatitis tended to be higher in patients with HBV infections than in those without (18.8% vs 8.91%, P = .082). Severe hepatitis (grade 3 or higher) was more common in HBV‐infected patients (12.5% vs 1.9%, P = .0021), but the AEs were well‐managed. During ICI treatment, three of the 20 patients with a history of pulmonary Tbc developed active pulmonary Tbc, considered reactivations. No aggravation of ILD was noted. One RA patient experienced a disease flare and was treated with a low‐dose steroid. There was no significant difference in the overall response rate or progression‐free survival between patients with and without special issues. Conclusion Given the relatively low incidence of immune‐related AEs and the comparability of clinical outcomes, ICIs can be treatment option of NSCLC patients with special issues.

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Section: Discussionmentioning

confidence: 91%

“…Tuberculosis is still a burdensome disease worldwide. With regard to pulmonary tuberculosis, only seven patients treated with ICIs have been described in previous reports, and the association of ICIs with Tbc reactivation remains ambiguous …”

Section: Introductionmentioning

confidence: 99%

PD‐1 inhibitors for non‐small cell lung cancer patients with special issues: Real‐world evidence

et al. 2020

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“…Of note, among patients without irAEs or additional immunosuppressive therapy, there exists a potential risk of reactivation of chronic/latent infections. Seven cases have been recently reported that describe reactivation of latent tuberculosis infection (LTBI), most occurring within three months after treatment with PD‐1/PD‐L1 inhibitors . The possible mechanism may involve a boost of T helper cell (TH)1 function, resembling the immune reconstitution inflammatory syndrome (IRIS) observed in HIV patients at the beginning of antiretroviral therapy.…”

Section: Clinical Data Review and Description Of Potential Mechanism mentioning

confidence: 99%

Recommendation for the diagnosis and management of immune checkpoint inhibitor related infections

Wang

et al. 2020

Thoracic Cancer

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Immune checkpoint inhibitors (ICIs) have been widely used in the management of malignant tumors. Programmed death 1 (PD‐1)/PD‐1 ligand (PD‐L1) inhibitors have been introduced to treat non‐small cell lung cancer (NSCLC) in recent years. Currently, PD‐1/PD‐L1 inhibitors are considered to have minor side effects and do not independently increase the risk of infection. However, they may cause immune‐related adverse events (irAEs) that require immunosuppressive therapy with corticosteroids and/or immunosuppressants, leading to opportunistic infections. Furthermore, there have been reports describing reactivation of chronic/latent infections without irAEs or having received immunosuppressants. Thus, immune checkpoint inhibitor related infections have received more attention worldwide. In this paper, we review available clinical data, describe the potential mechanism, and propose recommendations for the diagnosis and clinical management of PD‐1/PD‐L1 inhibitor‐related infections.

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“…One potential strategy to overcome the PD‐1/PD‐L1 mechanism in vaccine‐based immunotherapy is optimization of blockade. The clinical effect of blockade has been shown in a number of advanced malignancies . Another possible approach for reversing vaccination failure is to combine sPD‐1, which is a soluble form of PD‐1 detected in the blood of patients with autoimmune disease (AID), associated with intense inflammation through blockade of the PD‐1 suppressive pathway by interaction with PD‐L1 …”

Section: Introductionmentioning

confidence: 99%

“…The clinical effect of blockade has been shown in a number of advanced malignancies. 20,21 Another possible approach for reversing vaccination failure is to combine sPD-1, which is a soluble form of PD-1 detected in the blood of patients with autoimmune disease (AID), associated with intense inflammation through blockade of the PD-1 suppressive pathway by interaction with PD-L1. 22,23 In the present study, we found that senescent whole-tumor-cell vaccination significantly shifted DC towards maturity followed by Tcell activation in vivo.…”

Section: Introductionmentioning

confidence: 99%

Senescent cells re‐engineered to express soluble programmed death receptor‐1 for inhibiting programmed death receptor‐1/programmed death ligand‐1 as a vaccination approach against breast cancer

Feng

et al. 2018

Cancer Science

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Various types of vaccines have been proposed as approaches for prevention or delay of the onset of cancer by boosting the endogenous immune system. We previously developed a senescent‐cell‐based vaccine, induced by radiation and veliparib, as a preventive and therapeutic tool against triple‐negative breast cancer. However, the programmed death receptor‐1/programmed death ligand‐1 (PD‐1/PD‐L1) pathway was found to play an important role in vaccine failure. Hence, we further developed soluble programmed death receptor‐1 (sPD1)‐expressing senescent cells to overcome PD‐L1/PD‐1‐mediated immune suppression while vaccinating to promote dendritic cell (DC) maturity, thereby amplifying T‐cell activation. In the present study, sPD1‐expressing senescent cells showed a particularly active status characterized by growth arrest and modified immunostimulatory cytokine secretion in vitro. As expected, sPD1‐expressing senescent tumor cell vaccine (STCV/sPD‐1) treatment attracted more mature DC and fewer exhausted‐PD1+ T cells in vivo. During the course of the vaccine studies, we observed greater safety and efficacy for STCV/sPD‐1 than for control treatments. STCV/sPD‐1 pre‐injections provided complete protection from 4T1 tumor challenge in mice. Additionally, the in vivo therapeutic study of mice with s.c. 4T1 tumor showed that STCV/sPD‐1 vaccination delayed tumorigenesis and suppressed tumor progression at early stages. These results showed that STCV/sPD‐1 effectively induced a strong antitumor immune response against cancer and suggested that it might be a potential strategy for TNBC prevention.

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Development of pulmonary tuberculosis following treatment with anti-PD-1 for non-small cell lung cancer

Cited by 33 publications

References 5 publications

PD‐1 inhibitors for non‐small cell lung cancer patients with special issues: Real‐world evidence

PD‐1 inhibitors for non‐small cell lung cancer patients with special issues: Real‐world evidence

Recommendation for the diagnosis and management of immune checkpoint inhibitor related infections

Senescent cells re‐engineered to express soluble programmed death receptor‐1 for inhibiting programmed death receptor‐1/programmed death ligand‐1 as a vaccination approach against breast cancer

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