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ID 47730
file
title alternative
Analysis of nivolumab related interstitial lung disease in patient with non-small-cell lung cancer.
creator
Sakurashita, Hiroshi
Izumitani, Satoru
Kimura, Yumi
Nishigakiuchi, Ryo
Murase, Tetsuya
Motonaga, Masanori
Saeki, Yasuyuki
subject
ニボルマブ
間質性肺疾患
副腎皮質ステロイド治療
免疫関連有害事象
nivolumab
Interstitial Lung Disease
corticosteroid therapy
immune-related adverse event
abstract
ニボルマブに関連した間質性肺疾患(以下,ILD)の発現については,死亡例が報告され注意喚起がなされている。ILD 等の異常が認められた場合には,ニボルマブを中止し副腎皮質ステロイド剤の投与等の処置を行うこととされているが,十分なデータが得られているとは言えない。平成28年1~12月の間に非小細胞肺癌に対してニボルマブ投与を開始した患者の中でGrade 2及びGrade 3のILD各1名を経験し,メチルプレドニゾロンコハク酸エステルナトリウム1 g/day ×3日間投与後,経口プレドニゾロン投与し漸減することで軽快した。ILD の発現時期については,ニボルマブ2~ 12回目の投与時(中央値8回目)に発現しており定まっていなかった。今回経験したGrade 2以上の症例においては,副腎皮質ステロイドに対する反応性を認めた。
abstract
The attention is given to Nivolumab induced interstitial lung disease (refered to as ILD). In some cases, even deaths have been reported. The standard protocol is that once a sign of ILD is seen, stop Nivolumab and switch to corticosteriod, but there is no enough data to back up this protocol. Among the non-small cell lung cancer patients who were given Nivolumab between January 2016 and December 2016, there was one patient who experienced grade 2 ILD and another patient with grade 3 ILD. Both of these patients’ symptoms of ILD were mostly contained after given 1g/day of Methyprednisolone Soduim Succinate for 3 days, then oral prednisolones with gradually decreasing the dosage of it. Regarding the manifestation of ILD, it varied and it was somewhere bewteen second to 12th doses of Nivolumab with the median of 8th doses. This study was able to confirm the effective response to corticosteriod for grade 2 or higher cases of ILD.
journal title
Medical journal of Hiroshima Universtiy
volume
Volume 66
issue
Issue 1-6
start page
17
end page
21
date of issued
2018-12
publisher
広島大学医学出版会
issn
0018-2087
ncid
language
jpn
nii type
Departmental Bulletin Paper
HU type
Departmental Bulletin Papers
DCMI type
text
format
application/pdf
text version
publisher
rights
Copyright (c) 2018 広島大学医学出版会
department
Graduate School of Biomedical & Health Sciences
University Medical Hospital
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