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Title: Durvalumab induced sarcoid-like pulmonary lymphadenopathy.
Austin Authors: Sanderson, Emma ;Wimaleswaran, Hari ;Senko, Clare ;White, Shane ;McDonald, Christine F 
Affiliation: Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Medical Oncology, Austin Health, Heidelberg, Victoria, Australia
Faculty of Medicine, Dentistry and Health Sciences University of Melbourne Melbourne VIC Australia
Issue Date: Apr-2020 2020-02-25
Publication information: Respirology case reports 2020; 8(3): e00542
Abstract: Immune checkpoint inhibitors (ICIs) have become pivotal in the treatment of lung cancer. An increasing number of immune-related adverse events (irAEs) have been recognized with their use. To our knowledge, this is the first published case of sarcoid-like pulmonary lymphadenopathy associated with durvalumab, a monoclonal antibody against programmed death ligand-1 (PD-L1). A 76-year-old woman received adjuvant durvalumab for Stage IIA pT2aN1M0 (American Joint Committee on Cancer, Seventh edition) poorly differentiated lung adenocarcinoma. After three cycles, a sarcoid-like granulomatous reaction was identified in mediastinal and hilar lymph nodes. Although the lymphadenopathy remained stable in size with the ongoing treatment, progressive intracranial metastases were identified after a further three cycles of durvalumab. Sarcoid-like inflammation with the formation of non-caseating granulomas in the absence of systemic sarcoidosis is an irAE which may mimic disease progression. Although a subset of patients who experience this reaction may have a favourable response to checkpoint inhibition, progression of disease may occur contemporaneously.
DOI: 10.1002/rcr2.542
ORCID: 0000-0001-6481-3391
Journal: Respirology case reports
PubMed URL: 32110415
ISSN: 2051-3380
Type: Journal Article
Subjects: Durvalumab
immune checkpoint inhibition
Appears in Collections:Journal articles

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