Non-small-cell Lung Cancer with Severe Skin Manifestations Related to Radiation Recall Dermatitis after Atezolizumab Treatment

Intern Med. 2020 May 1;59(9):1199-1202. doi: 10.2169/internalmedicine.3937-19. Epub 2020 Feb 12.

Abstract

Radiation recall dermatitis (RRD) is an inflammatory reaction that occurs at previously irradiated skin regions after drug administration. We herein report a patient with non-small-cell lung cancer treated previously with thoracic radiotherapy who developed severe RRD induced by atezolizumab [anti-programmed death 1 ligand 1 (PD-L1) antibody]. Immunohistochemistry of the skin biopsy showed dermatitis with infiltration of CD8+ lymphocytes, suggesting that atezolizumab might provoke an immune-related inflammatory reaction at previously irradiated skin regions. When administering anti-PD-L1 antibody to patients who have undergone radiotherapy previously, physicians should carefully monitor the irradiated skin for the potential occurrence of RRD.

Keywords: atezolizumab; non-small cell lung cancer; radiation recall dermatitis.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antineoplastic Agents / adverse effects
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Combined Modality Therapy / adverse effects
  • Diagnosis, Differential
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • Radiodermatitis / chemically induced
  • Radiodermatitis / diagnosis*
  • Radiodermatitis / pathology
  • Severity of Illness Index

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • atezolizumab