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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: Respiratory and Sleep Medicine
Medical Oncology
Faculty of Medicine, Dentistry and Health Sciences University of Melbourne Melbourne VIC Australia
Issue Date: Apr-2020
Date: 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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