Regression of Lung Squamous Cell Carcinoma after the Withdrawal of Cyclosporin A Combined with Pirfenidone Treatment in a Patient with Idiopathic Pulmonary Fibrosis

Intern Med. 2021 Feb 15;60(4):617-621. doi: 10.2169/internalmedicine.5125-20. Epub 2020 Oct 7.

Abstract

A 72-year-old man was treated with prednisolone and cyclosporine A for idiopathic pulmonary fibrosis. A nodule with a diameter of 19 mm was found in the right lung and diagnosed as lung squamous cell carcinoma. Anti-cancer treatments were not performed because of the presence of advanced interstitial pneumonia and chronic respiratory failure. Cyclosporine A was tapered to avoid suppression of anti-tumor immunity, and pirfenidone was initiated. Within 2 months, the tumor had shrunk to 10 mm in diameter and remained regressed for 9 months. This is the first report of a non-hematologic solid organ tumor responding to the discontinuation of immunosuppressants.

Keywords: cyclosporine A; idiopathic pulmonary fibrosis; immunosuppressants; lung cancer; pirfenidone.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Carcinoma, Squamous Cell* / drug therapy
  • Cyclosporine / therapeutic use
  • Humans
  • Idiopathic Pulmonary Fibrosis* / drug therapy
  • Lung
  • Lung Neoplasms* / drug therapy
  • Male
  • Pyridones / therapeutic use
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Pyridones
  • Cyclosporine
  • pirfenidone