Tuberculous Lymphadenitis in a Patient Receiving PD-1 Inhibitor for Melanoma: A Case Report and Brief Literature Review
CURRENT ONCOLOGY, vol.28, no.1, pp.260-264, 2021 (SCI-Expanded, Scopus)
- Publication Type: Article / Review
- Volume: 28 Issue: 1
- Publication Date: 2021
- Doi Number: 10.3390/curroncol28010028
- Journal Name: CURRENT ONCOLOGY
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
- Page Numbers: pp.260-264
- Keywords: tuberculous lymphadenitis, nivolumab, melanoma, immune checkpoint inhibitors, immunotheraphy
- Open Archive Collection: AVESIS Open Access Collection
- Dokuz Eylül University Affiliated: Yes
Abstract
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.