Sustained complete response of metastatic cutaneous squamous cell carcinoma by immune checkpoint inhibition in a renal transplant patient: a case report

Su, T; Rácz, Emőke; Wiegman, Marchien J.; Crop, Meindert J.; Broekman, K.E.

doi:10.1111/jdv.18262

Cited by 2 publications

(2 citation statements)

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“…Immunotherapy is known to increase the risk of infection by causing immunosuppression ( 8 ). Investigators found that, among a retrospective cohort of 111 patients with various solid malignancies treated with immunotherapy, the overall serious infection (requiring hospital admission and/or intravenous antibiotics) rate was 14% ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Immunotherapy may increase the risk of infections or modify the coverage provided by vaccination post-splenectomy. Additionally, the patient's immune-related grade 3 diarrhea, which was assumed to be colitis, was treated with the tumor necrosis factor-alpha (TNF-a) inhibitor infliximab and steroids, which likely further enhanced the immunosuppression (8,9). OPSI is a rare condition (prevalence rate, 0.1%-0.5%).…”

Section: Discussionmentioning

confidence: 99%

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Case report: Fatal overwhelming post-splenectomy infection in a patient with metastatic angiosarcoma treated with immunotherapy

Torrado,

Baysal,

Chakraborty

et al. 2024

Front. Immunol.

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A patient in his 40s with splenic angiosarcoma metastatic to the liver underwent splenectomy, chemotherapy, and partial hepatectomy before being treated on a clinical trial with CTLA4 and PD1 inhibitors. He had received pneumococcal and meningococcal vaccines post-splenectomy. On week 10, he developed grade 3 immune-related colitis, successfully treated with the anti-tumor necrosis factor-alpha inhibitor infliximab and steroids. After 4 cycles of treatment, scans showed partial response. He resumed anti-PD1 therapy, and 6 hours after the second dose of anti-PD1 he presented to the emergency room with hematemesis, hematochezia, hypotension, fever, and oxygen desaturation. Laboratory tests demonstrated acute renal failure and septicemia (Streptococcus pneumoniae). He died 12 hours after the anti-PD1 infusion from overwhelming post-splenectomy infection (OPSI). Autopsy demonstrated non-viable liver tumors among other findings. In conclusion, patients undergoing immunotherapy and with prior history of asplenia should be monitored closely for OPSI as they may be at increased risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%