Radiation recall pneumonitis induced by nivolumab in a patient with renal cell carcinoma

Nakamura, Kenji; Okubo, Kazutoshi; Takahashi, Takeshi; Mitsumori, Kenji; Ishigaki, Takashi; Ohnishi, Hiroyuki

doi:10.1002/iju5.12032

Cited by 9 publications

(7 citation statements)

References 21 publications

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“…Radiotherapy induction led to the development of CIP in 4 patients; they did not develop pneumonitis before nonthoracic radiotherapy but rapidly developed pneumonitis after radiation therapy. Pneumonitis occurs in previously irradiated lungs, which is known as radiation recall pneumonitis (RRP) (43)(44)(45). Contrastingly, tumor regression in the unirradiated field has been found, which is known as the abscopal effect (46)(47)(48).…”

Section: Discussionmentioning

confidence: 99%

Clinical types of checkpoint inhibitor-related pneumonitis in lung cancer patients: a multicenter experience

Lin¹,

Deng²,

Chen³

et al. 2021

Transl Lung Cancer Res

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Background: Checkpoint inhibitor-related pneumonitis (CIP) is not well classified according to clinical factors. We propose different clinical sub-types of CIP based on clinical factors and investigated the corresponding clinical features, treatments, and outcomes. Methods:We conducted a multicenter retrospective study of patients with lung cancer (including nonsmall cell lung cancer and small cell lung cancer) who developed CIP. The clinical characteristics, radiologic features, treatments, and outcomes of CIP were analyzed.Results: A total of 55 patients developed CIP and were classified into 3 groups as follows: 21 in the pure type (PT) group, 14 in the induced type (IT) group, and 20 in the mixed type (MT) group. The incidence of severe (grade 3-5) pneumonitis was significantly higher in the IT group than in the PT and MT groups (71.4% vs. 14.3% vs. 50.0%, P=0.002). Antiviral therapy was significantly more frequent in the IT group than in the PT and MT groups. Antibiotic therapy was administered in 23.8%, 71.4%, and 80.0% of patients with the PT, IT, and MT, respectively. The improvement time in the PT group was longer than that in the IT and MT groups (0.9 vs. 0.5 vs. 0.3 months, P=0.028). Patients with the PT had a better tumor response to immune checkpoint inhibitors (ICIs) than those with the other 2 types [overall response rate (ORR), 78% vs. 31% vs. 44%, P=0.027]. Conclusions:The clinical classification of CIP may favor strategies for treatments and predict the tumor response to ICIs.

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Section: Discussionmentioning

confidence: 99%

Clinical types of checkpoint inhibitor-related pneumonitis in lung cancer patients: a multicenter experience

Lin¹,

Deng²,

Chen³

et al. 2021

Transl Lung Cancer Res

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“…It was previously speculated that these factors induce resistance to additional chemotherapy and cause inflammatory responses. Notably, it is not only caused by non-cytotoxic drugs such as tamoxifen but also by recently developed immune checkpoint inhibitors [3][4][5]. Therefore, immunity is also considered to be an influencing factor, but the mechanism is still unknown.…”

Section: Discussionmentioning

confidence: 99%

A Case of Suspected Radiation Recall Pneumonitis After a COVID-19 Infection

Kurosaki¹,

Utsumi²,

Miura³

2021

Cureus

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We present the case of a 78-year-old woman who received definitive radiation therapy for small cell lung cancer three and a half years ago. She was asymptomatic when she tested positive for coronavirus disease 2019 (COVID-19). She then developed a rapid decline in respiratory status on day seven. Chest radiograph revealed a strong shadow at the prior irradiation site. Radiation recall reactions are usually caused by drug administration, but in this case, it was suspected to be caused by COVID-19.

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“…The incidence of RRPn induced by nivolumab had also been reported in a patient with renal cell carcinoma after palliative radiation (30 Gy in 10 fractions) to the ribs. 19 Three days after the nivolumab administration, she presented with respiratory symptoms, and CECT scan image suggested recall pneumonitis.…”

Section: Radiation Recall Pneumonitismentioning

confidence: 99%

“Radiation Recall Phenomenon” with Novel Cytotoxic Agents: An Emerging Trend in the Last Decade

Mandal

Singh

Tandon

et al. 2021

Indian Journal of Medical and Paediatric Oncology

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Radiation recall phenomenon (RRP) is an acute inflammatory reaction manifested in the previously irradiated tissues after the administration of various pharmacologic compounds. While skin manifestations are the most common clinical features, patients may also present with visceral recall events including pneumonitis, hematuria, myopathy, and mucositis if any particular organ was exposed to the prior radiation portals. This article has reviewed the published case reports, case series, abstracts, and poster presentations in the past 10 years in any language on RRP caused by various novel cytotoxic drugs including immunotherapies, molecularly targeted agents, and unconventional chemotherapies. We retrieved the data through the literature search of MEDLINE and PubMed using the keywords “radiation,” “recall,” “targeted therapy,” and “immunotherapy,” and references identified in retrieved articles were also used for further search of the literature. With the increasing use of unconventional, novel cytotoxic agents and targeted molecules, concurrent or sequentially with radiation, we expect more incidences of RRP in future that may present with either dermatological or visceral recall reactions.

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Radiation recall pneumonitis induced by nivolumab in a patient with renal cell carcinoma

Cited by 9 publications

References 21 publications

Clinical types of checkpoint inhibitor-related pneumonitis in lung cancer patients: a multicenter experience

Clinical types of checkpoint inhibitor-related pneumonitis in lung cancer patients: a multicenter experience

A Case of Suspected Radiation Recall Pneumonitis After a COVID-19 Infection

“Radiation Recall Phenomenon” with Novel Cytotoxic Agents: An Emerging Trend in the Last Decade

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