The recent introduction of checkpoint inhibitor–based immunotherapy has revolutionized the treatment of advanced lung cancers, becoming standard of care in both first- and second-line treatment. New types of toxicity are emerging with the increasingly widespread use of these inhibitors.
Case presentation:
We describe a case of aplastic anemia in a patient with stage IV non-small cell lung cancer after a single administration of nivolumab.
Conclusions:
Several similar case reports reported in literature show an increasing rate of toxicities from immunotherapy in this setting. These real-world data provide an insight into patient outcomes and treatment decisions being made in clinical practice.
BorghaeiHPaz-AresLHornL, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med2015; 373: 1627–1639.
2.
ChampiatSLambotteOBarreauE, et al. Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper. Ann Oncol2016; 27: 559–574.
3.
PostowMASidlowRHellmannMD. Immune-related adverse events associated with immune checkpoint blockade. N Engl J Med2018; 378: 158–168.
4.
KarakasYYucaDKilickapS. Immune thrombocytopenia induced by nivolumab in a metastatic non-small cell lung cancer patient. Oncol Res Treat2017; 40: 621–622.
5.
YukiATakenouchiTTakatsukaSIshiguroT. A case of pure red cell aplasia during nivolumab therapy for cardiac metastatic melanoma. Melanoma Res2017; 27: 635–637.
6.
HelgadottirHKisLLjungmanP, et al. Lethal aplastic anemia caused by dual immune checkpoint blockade in metastatic melanoma. Ann Oncol2017; 28: 1672–1673.
ShiuanEBeckermannKEOzgunA, et al. Thrombocytopenia in patients with melanoma receiving immune checkpoint inhibitor therapy. J Immunother Cancer2017; 5: 8.
9.
ComitoRRBaduLAForcelloN. Nivolumab-induced aplastic anemia: a case report and literature review. J Oncol Pharm Pract2019; 25: 221–225.
10.
BrahmerJRLacchettiCSchneiderBJ, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol2018; 36: 1714–1768.
