• Xian Miao, Shu Dong, Yuhua Tao, Xiaohui Yang, and Shuijie Shen.
• Department of Oncology, Nantong Hospital Affiliated to Nanjing University of Chinese Medicine, Nantong, China.
• Medicine (Baltimore). 2024 Mar 8; 103 (10): e37434e37434.

RationaleImmune checkpoint inhibitors have shown high efficacies as the first-line treatment of various advanced malignancies. Yet, the effect and practice patterns of immune checkpoint inhibitors on the second primary tumors are still unclear. Second primary malignancy post immunotherapy, there is paucity in such cases being reported.Patient ConcernsWe report 2 cases of a 57-year-old woman with nonsmall cell lung cancer and a 69-year-old man with metastatic clear cell renal carcinoma treated with immunotherapy who developed second primary malignancies during the therapy.DiagnosisSecond primary malignancy during the therapy.InterventionsIn addition to the treatments of the second primary malignancies, maintenance immunotherapy was continued for the patients.OutcomesOverall survival in both patients was longer than 12 months, and the treatments were well tolerated. The adverse reactions mainly included depigmentation of hair and facial and limb skin in patient 1 and diarrhea in patient 2.LessonsIt is necessary to recognize that the second primary malignancy may occur during the immunotherapy, and more clinical studies and practices are still needed for the adjustment of the regimens of immunotherapy. Full diagnosis, timely treatment, and long-term regular follow-up have important significance for patients with malignancies.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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