Psoriatic arthritis due to nivolumab administration a case report and review of the literature

Sapalidis, Konstantinos; Kosmidis, Christoforos; Michalopoulos, Nikolaos; Koulouris, Charilaos; Mantalobas, Stylianos; Giannakidis, Dimitrios; Munteanu, Alexandru Claudiu; Șurlin, Valeriu; Laskou, Styliani; Drougas, Dimitrios; Sardeli, Chrysanthi; Karapantzou, Chrysanthi; Karapantzos, Ιlias; Hohenforst-Schmidt, Wolfgang; Huang, Haidong; Κεσίσογλου, Ισαάκ

doi:10.1016/j.rmcr.2018.03.001

Cited by 18 publications

(16 citation statements)

References 17 publications

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“…Sapalidis et al presented a case report of a patient with lung adenocarcinoma in second-line treatment with nivolumab who underwent psoriatic arthritis. The patient was treated with Apremilast, interrupting immunotherapy ( 20 ). Moreover, Apalla et al reported one case of a woman with lung adenocarcinoma and nivolumab-induced psoriasis treated effectively with Apremilast.…”

Section: Discussionmentioning

confidence: 99%

Pembrolizumab-Induced Psoriasis in Metastatic Melanoma: Activity and Safety of Apremilast, a Case Report

et al. 2020

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Background Immune checkpoint inhibitors targeting cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), programmed death-1 receptor (PD-1), and programmed death-1 receptor and its ligand (PD-L1) increased the survival of patients affected by metastatic malignant melanoma. Due to their mechanism of action, these drugs are associated with a unique toxicity profile. Indeed, immune-related adverse events (irAEs) present a wide clinical spectrum representing the Achilles’ heel of immunotherapy. Overall, cutaneous toxicities are among the most common irAEs. Immunomodulatory drugs are used for the management of irAEs and can theoretically lead to tumor escape. Case Presentation We report the case of a 75-year-old man with metastatic melanoma receiving the anti-PD1 Pembrolizumab therapy. After 10 treatment cycles, the patient came to our clinic with itchy psoriatic manifestations widespread >30% of the body surface [12.3 Psoriasis Area and Severity Index (PASI) score] that negatively impacted on the patient’s quality of life and compliance with immunotherapy. Additionally, he had no positive personal history of psoriasis. Given the severity of the cutaneous manifestations, in a multidisciplinary approach, Apremilast (an oral small molecule PDE4 inhibitor) was started. Furthermore, Pembrolizumab was interrupted for 4 weeks until the improvement of skin lesions and the disappearance of itching. Immunosuppressive methylprednisolone therapy was initiated with a dose of 16 mg/die; then, this initial dose was progressively reduced until discontinuation. After 10 months, the patient had a good general clinical condition with psoriasis complete remission. Moreover, positron emission tomography (PET) and computed tomography (CT) scans showed complete response by immune Response Evaluation Criteria in Solid Tumors (iRECIST). Conclusion To the best of our knowledge, this is the first report on the safety and efficacy of Apremilast for the treatment of immunotherapy-induced psoriasis in metastatic melanoma.

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Section: Discussionmentioning

confidence: 99%

Pembrolizumab-Induced Psoriasis in Metastatic Melanoma: Activity and Safety of Apremilast, a Case Report

et al. 2020

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“…In any case it is a very efficient treatment modality. However; immunotherapy in lung cancer has numerous side effects such as tumor necrosis syndrome, vitiligo, psoriasis, acute thyroiditis and hepatitis resuscitation [ [20] , [21] , [22] , [23] ]. Uveitis, pancreatitis, central nervous system disease, and peripheral neuropathies have also been reported [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Acute pneumothorax due to immunotherapy administration in non-small cell lung cancer

Sardeli

Romanidis

Οικονόμου

et al. 2020

Respiratory Medicine Case Reports

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Nowadays we have novel therapies for advanced stage non-small cell lung cancer. Immunotherapy has been introduced in the market for several years and until now its administration is mostly based on the programmed death-ligand 1. First line treatment with immunotherapy can be administered alone if programmed death-ligand 1 expression is ≥ 50%. All therapies for advanced stage disease have advantages and disadvantages, immunotherapy until now has presented mild adverse effects when compared to chemotherapy. However; it is known to induce inflammatory response to different tissues within the body. In our case acute pneumothorax was induced after immunotherapy administration.

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“…Moreover; after we acquire biopsy we investigate for the following gene expressions growth factor receptor (EGFR) or T790M, anaplastic lymphoma kinase (ALK), Programmed death-ligand 1 (PD-L1), Proto-oncogene tyrosine-protein kinase ROS-1, R ET proto-oncogene encodes and proto-oncogene B-Raf (9,12). All these treatments of course have their adverse effects that the treating physician has to overcome (13,14).…”

Section: Introductionmentioning

confidence: 99%

Lung cancer, treatment and nutritional status

et al. 2021

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Lung cancer is often diagnosed at inoperable advanced stages, and most patients exhibit cancer cachexia. The nutritional status of patients has been previously observed to serve a key role in cancer survival and cancer surgery. The aim of the current study was to collect information regarding the treatment of patients and associate them with different nutritional measurements. A total of 82 patients with non-small cell lung cancer were included in the present study. Several parameters were assessed, such as body mass index (BMI), Mediterranian diet score, number of years spent smoking, basic metabolsim (RMR; kcal/day), VO 2 (ml/min), ventilation (lt/min) and physical activity. All the aforementioned parameters were associated with patient treatment, nutritional status and survival. Two-way ANOVA was conducted and pairwise group mean differences were tested using Fisher's LSD and Tukey tests. Normality and variance homogeneity was checked in all cases. The results revealed that RMR and oxygen consumption were negatively affected by the survival status of patients (P=0.012 and P=0.043, respectively). The mean fat difference was higher in patients treated with immunotherapy, and lower in those treated with chemotherapy in addition to immunotherapy, as demonstrated by Tukey comparisons. The survival of 25 patients were affected by the treatment they received (P=0.006). Chemotherapy administered in addition to immunotherapy prolonged patient life almost two-fold when compared with the individual effects of the two treatments, which became equal according to Fisher's LSD comparisons.In conclusion, the nutritional status of patients was associated with the administration of chemotherapy in addition to immunotherapy, and patient survival. Increased metabolism and fat mass were also associated with prolonged survival.

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Psoriatic arthritis due to nivolumab administration a case report and review of the literature

Cited by 18 publications

References 17 publications

Pembrolizumab-Induced Psoriasis in Metastatic Melanoma: Activity and Safety of Apremilast, a Case Report

Pembrolizumab-Induced Psoriasis in Metastatic Melanoma: Activity and Safety of Apremilast, a Case Report

Acute pneumothorax due to immunotherapy administration in non-small cell lung cancer

Lung cancer, treatment and nutritional status

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