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Activated pulmonary tuberculosis in a patient with melanoma during PD-1 inhibition: a case report

Authors He W, Zhang XM, Li WW, Kong C, Wang YY, Zhu LY, Xu RL, Deng GF, Zhang PZ

Received 26 June 2018

Accepted for publication 6 September 2018

Published 24 October 2018 Volume 2018:11 Pages 7423—7427

DOI https://doi.org/10.2147/OTT.S178246

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Arseniy Yuzhalin


Wan He,1,* Xiangmei Zhang,2,* Wenwen Li,1 Cheng Kong,1 Yuanyang Wang,3 Lianyu Zhu,1 Ruilian Xu,1 Guofang Deng,4 Peize Zhang4

1Department of Oncology, The Second Clinical Medical College, Shenzhen People’s Hospital, Jinan University, Shenzhen, Guangdong 518020, China; 2Department of Pathology, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong 518112, China; 3Department of Surgery, The Second Clinical Medical College, Shenzhen People’s Hospital, Jinan University, Shenzhen, Guangdong 518020, China; 4Department of Pulmonary Medicine, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong 518112, China

*These authors contributed equally to this work

Background: PD-1 checkpoint inhibitors have shown a robust tumor response in the treatment of various cancers. Pembrolizumab is an anti-PD-1 checkpoint antibody approved for the treatment of unresectable or metastatic melanoma in more than 40 countries. Although autoimmune pneumonitis is considered a common immune-related adverse event of PD-1 inhibitors, only limited studies have assessed the development of opportunistic infections such as pulmonary tuberculosis (TB).
Case presentation:
A patient with metastatic melanoma whose pulmonary TB was activated after administration of pembrolizumab for melanoma is reported. Anti-TB drugs were administered, followed by pembrolizumab (2 mg/kg, repeated every 28 days), which successfully cured the TB and achieved complete response for melanoma.
Conclusion: Activated pulmonary TB was observed during the administration of pembrolizumab. It was safe and effective in the current patient to combine anti-TB drugs and PD-1 inhibitors. More importantly, screening pulmonary TB before administration of PD-1 inhibitors is recommended.

Keywords: checkpoint inhibitor, PD-1, pembrolizumab, metastatic melanoma, pulmonary tuberculosis, anti-tuberculosis treatment

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