Pembrolizumab‐induced sarcoidal infusion site reaction

Smith, Robert J.; Mitchell, Tara C.; Chu, Emily Y.

doi:10.1111/cup.13307

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…Table 1 summarizes the studies reporting clinically evident sarcoidosis and SLRs related to ICIs therapy, published in the English literature so far, including information about the type of malignancy, type of ICI, sarcoidosis phenotype, type of treatment and survival of ICI. Including our patient, we were able to identify 80 individuals developing sarcoidosis or SLR in association to ICIs treatment 3‐54 . Based on these records, both sexes were equally affected (40 M/40F), whilst by far the most common malignancy was melanoma (65/80, 81.3%), with only 15 of 80 cases (18.8%) being other than melanoma tumors.…”

Section: Resultsmentioning

confidence: 99%

“…However, there is an on‐going controversy in regards with the relationship between sarcoidosis and malignancies, given that sarcoidosis may develop during the course of an oncologic disease and vice versa 1 . Furthermore, sarcoidosis, or sarcoid‐like reactions (SLRs) may develop in association to certain oncologic drugs, including immune checkpoint inhibitors (ICIs) 1,3‐54 . As expected, the aforementioned facts raise significant diagnostic and therapeutic challenges in oncologic patients treated with ICIs.…”

Section: Introductionmentioning

confidence: 99%

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Challenges in sarcoidosis and sarcoid‐like reactions associated to immune checkpoint inhibitors: A narrative review apropos of a case

Apalla

Kemanetzi

Papageorgiou

et al. 2020

Dermatologic Therapy

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Sarcoidosis and sarcoid‐like reactions (SLRs) may develop in association with various malignancies, as well as in association to certain oncologic drugs, including immune checkpoint inhibitors (ICIs). We aimed to perform a narrative review with regard to the development of ICIs‐associated sarcoidosis or SLRs, and to discuss the corresponding diagnostic and therapeutic challenges raised in this scenario. Apropos of a melanoma patient developing SLRs while treated with ipilimumab and nivolumab, we searched for clinically evident, ICIs‐associated sarcoidosis or SLRs in the English literature. We recorded the oncologic characteristics, including type of malignancy and type of ICI, the phenotypic characteristics of sarcoidosis/SLRs, as well as the impact on immunotherapy. Including our patient, we identified 80 ICIs‐associated sarcoidosis or SLRs cases. Both sexes were equally affected (40 F/40 M) and the most common malignancy was melanoma (65/80, 81.3%). Concerning the oncologic treatment, there was a predilection for pembrolizumab (23/80, 28.7%), followed by the ipilimumab/nivolumab combination (21/80, 26.3%), ipilimumab (18/80, 22.5%), nivolumab (16/80, 20.0%). Although in the majority of the cases (52/80, 65.0%) there was no need for systemic prednisolone for the management of sarcoidosis, a significant proportion of patients finally discontinued ICIs treatment (44/80, 55.0%). Phenotypically, sarcoidosis and SLRs highly imitate oncologic progression posing diagnostic difficulties. A therapeutic dilemma is also raised when there is a need for systemic prednisolone, since the latter may jeopardize the therapeutic efficacy of immunotherapy. Sarcoidosis and SLRs, though rare, can present in oncologic patients treated with ICIs. Clinicians should be aware of this possibility and the related diagnostic and therapeutic challenges they have to face in this scenario.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Challenges in sarcoidosis and sarcoid‐like reactions associated to immune checkpoint inhibitors: A narrative review apropos of a case

Apalla

Kemanetzi

Papageorgiou

et al. 2020

Dermatologic Therapy

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“…Lung parenchyma (30,29); cutaneous (44,42); hilar lymph nodes (64,62); mediastinal lymph nodes (66,64); bone (5,5); neural tissue (3,3); kidney (1, 1); extrathoracic lymph nodes (5,5); spleen (4, 4); eye (5,5) Abbreviations: adenoCa, adenocarcinoma; Ca, carcinoma; ICI, immune checkpoint inhibitor; NSCLC, non-small cell lung cancer; RCC, renal cell carcinoma, SLR, sarcoid-like reaction.…”

Section: Site Of Slr Bmentioning

confidence: 99%

Suspected immune checkpoint inhibitor‐induced pulmonary sarcoid reaction in metastatic renal cell carcinoma

Purcell

Preti

Fernandes

2022

Clinical Case Reports

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We present the case of a 50-year-old male patient with metastatic clear cell renal cell carcinoma (mRCC) who developed a diffuse pulmonary opacification and lymphadenopathy during nivolumab maintenance therapy. This was diagnosed as presumed sarcoid granulomatous inflammatory reaction secondary to immunotherapy, which resolved with holding off therapy and the nivolumab was resumed. K E Y W O R D Simmune-related adverse events, immunotherapy, metastatic renal cell carcinoma, sarcoid-like reactions How to cite this article: Purcell V, Preti B, Fernandes R. Suspected immune checkpoint inhibitor-induced pulmonary sarcoid reaction in metastatic renal cell carcinoma.

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