Title |
Thoracic and cutaneous sarcoid-like reaction associated with anti-PD-1 therapy: longitudinal monitoring of PD-1 and PD-L1 expression after stopping treatment
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Published in |
Journal for Immunotherapy of Cancer, June 2018
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DOI | 10.1186/s40425-018-0372-4 |
Pubmed ID | |
Authors |
Léa Paolini, Caroline Poli, Simon Blanchard, Thierry Urban, Anne Croué, Marie-Christine Rousselet, Sarah Le Roux, Nathalie Labarrière, Pascale Jeannin, José Hureaux |
Abstract |
Immune checkpoint inhibitors (ICI) target T cell inhibitory pathways that are responsible for cancer tolerance by down-modulating immune functions. ICI have revolutionized patients care with lung cancer. Nevertheless, restoring endogenous antitumor T-cell responses can induce immune related adverse events, such as sarcoidosis. We report here the first case of a thoracic and cutaneous sarcoid-like reaction in a patient with a relapsing unresectable non-small cell lung cancer (NSCLC) treated with nivolumab, an anti-PD-1 mAb. The expression of PD-1 and its ligands, PD-L1 and PD-L2, was assessed by flow cytometry on peripheral blood mononuclear cells (PBMC) and compared to patients who had discontinued nivolumab therapy without having developed any immune related adverse events. PD-L1 expression was transiently increased on B cells, T cells and monocytes, whereas PD-L2 expression was not modulated. PD-1 was transiently undetectable when PD-L1 was maximal, before returning to basal level. Sarcoidosis spontaneously resolved, without corticotherapy. This case sheds the light on a complex regulation of PD-L1 expression in vivo on PBMC after nivolumab arrest and triggers the question of monitoring the expression of immune checkpoint on immune cells during and after treatment with ICI. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 3 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 33% |
Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 31 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 7 | 23% |
Student > Bachelor | 5 | 16% |
Student > Master | 3 | 10% |
Student > Doctoral Student | 2 | 6% |
Researcher | 2 | 6% |
Other | 6 | 19% |
Unknown | 6 | 19% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 14 | 45% |
Agricultural and Biological Sciences | 2 | 6% |
Immunology and Microbiology | 1 | 3% |
Biochemistry, Genetics and Molecular Biology | 1 | 3% |
Social Sciences | 1 | 3% |
Other | 1 | 3% |
Unknown | 11 | 35% |