Bronchiolitis obliterans syndrome associated with an immune checkpoint inhibitor in a patient with non-small cell lung cancer

Kenichiro Takeda; Hideki Miwa; Masato Kono; Ryutaro Hirama; Yuiko Oshima; Yasutaka Mochizuka; Akari Tsutsumi; Yoshihiro Miki; Dai Hashimoto; Hidenori Nakamura

doi:10.1016/j.rmcr.2023.101824

Bronchiolitis obliterans syndrome associated with an immune checkpoint inhibitor in a patient with non-small cell lung cancer

Respir Med Case Rep. 2023 Feb 26:42:101824. doi: 10.1016/j.rmcr.2023.101824. eCollection 2023.

Authors

Affiliations

¹ Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
² Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.
³ Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Abstract

A 75-year-old woman was admitted to our hospital with progressive dyspnea 7 months after second-line treatment with pembrolizumab for advanced non-small cell lung cancer. Chest radiography revealed hyperinflation in both lung fields, and pulmonary function tests revealed severe obstructive dysfunction without bronchodilator reversibility. There were no identifiable causes such as infections or autoimmune diseases. Therefore, bronchiolitis obliterans syndrome associated with immune checkpoint inhibitors was clinically diagnosed. Pembrolizumab was discontinued, but the respiratory dysfunction was irreversible and resulted in death. Bronchiolitis obliterans syndrome is an extremely rare but potentially severe adverse event associated with immune checkpoint inhibitor-related lung disease.

Keywords: Bronchiolitis obliterans syndrome; Immune checkpoint inhibitor; Immune-related adverse events; Non-small cell lung cancer; Pembrolizumab.

Publication types

Case Reports