Tuberculous Lymphadenitis in a Patient Receiving PD-1 Inhibitor for Melanoma: A Case Report and Brief Literature Review


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Akagunduz B., Ozer M., Bozkına A. Ç., Lebe B.

CURRENT ONCOLOGY, cilt.28, sa.1, ss.260-264, 2021 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 28 Sayı: 1
  • Basım Tarihi: 2021
  • Doi Numarası: 10.3390/curroncol28010028
  • Dergi Adı: CURRENT ONCOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.260-264
  • Anahtar Kelimeler: tuberculous lymphadenitis, nivolumab, melanoma, immune checkpoint inhibitors, immunotheraphy, LYMPH-NODE METASTASIS, IMMUNE, ANTIBODY, PET/CT
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Oncolytic immunotherapy is a novel and promising approach in clinical oncology practice. Currently, immune checkpoint inhibitors (ICIs) are the first-line treatment options for disseminated melanoma. Nivolumab is a well-defined ICI that blocks programmed cell death 1 (PD-1) and mainly increases anti-tumor immunity. The opportunistic infections are not expected with ICI therapies due to their immune reactivation effects. To date, only a few cancer patients have been reported with activated TB during ICI therapy. Here, we presented a young female patient diagnosed with histologically-confirmed tuberculous lymphadenitis while on nivolumab therapy for metastatic melanoma. The current case report represents the first described tuberculous lymphadenitis case related to anti-PD-1 based monoclonal antibody therapy. The mechanism underlying the development of TB with PD-1 inhibitor use has not been illuminated yet. Triggering of excessive inflammatory responses with ICIs therapy is a potential cause. Considering the increased utilization of ICI-based immunotherapies, the TB screening should be considered in all patients before starting PD-1 inhibitor therapy.