• Internal medicine · Jun 2021

    Case Reports

    Readministration of Pembrolizumab after Treatment of Tuberculosis Activated by Initial Pembrolizumab Therapy.

    • Shuji Murakami, Ryou Usui, Yoshiro Nakahara, Tetsuro Kondo, Terufumi Kato, and Haruhiro Saito.
    • Department of Thoracic Oncology, Kanagawa Cancer Center.
    • Intern. Med. 2021 Jun 1; 60 (11): 1743-1746.

    AbstractIncreasing the T-cell immune response to Mycobacterium tuberculosis with an anti-programmed cell death 1 (anti-PD-1) antibody may ultimately have detrimental effects. We present the case of a patient with advanced non-small cell lung cancer who developed active tuberculosis (TB) after initial treatment with pembrolizumab, an anti-PD-1 antibody. Pembrolizumab was resumed after completing anti-TB treatment, and no relapse of TB was observed clinically or radiologically. Checkpoint inhibitor-related pneumonitis (CIP) is first suspected when a pulmonary shadow presents during treatment with an anti-PD-1 antibody. It is sometimes difficult to diagnose CIP using computed tomographic images alone. Careful testing, including bacterial examinations and bronchoscopic biopsy, should be performed.

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