Pembrolizumab-induced Radiation Recall Pneumonitis After the Resolution of Typical Asymptomatic Radiation Pneumonitis

J UOEH. 2020;42(3):261-266. doi: 10.7888/juoeh.42.261.

Abstract

Radiation recall pneumonitis is a phenomenon in which a recall-triggering drug induces an acute inflammatory reaction in the lungs, corresponding to a previously irradiated area. Radiation recall reactions have been reported to occur following treatments with various cytotoxic anticancer agents and molecular-targeting drugs; however, only a few reports have described immune checkpoint inhibitor-induced radiation recall pneumonitis. We report a case of radiation recall pneumonitis induced by pembrolizumab in a patient with the postoperative local recurrence of non-small cell lung cancer. This case demonstrated that pembrolizumab might cause severe radiation recall pneumonitis, even after typical radiation pneumonitis has been resolved.

Keywords: non-small cell lung cancer; pembrolizumab; radiation pneumonitis; radiation recall reaction; radiotherapy.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Asymptomatic Diseases*
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Combined Modality Therapy
  • Humans
  • Lung Neoplasms / therapy*
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / radiotherapy
  • Radiation Pneumonitis / etiology*
  • Radiotherapy / adverse effects*

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • pembrolizumab