An Extremely Rapid Case of Pneumonitis with the Use of Nivolumab for Pancreatic Adenocarcinoma.
An Extremely Rapid Case of Pneumonitis with the Use of Nivolumab for Pancreatic Adenocarcinoma.
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DOI：
10.1155/2018/6314392
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发表时间：
2018
影响因子：
0.9
通讯作者：
Kalyan A
中科院分区：
文献类型：
--
作者：
Costa RB;Benson A;Yaghmai V;Costa RLB;Zhou H;Behdad A;Kaplan JB;Sadim M;Talamantes S;Kalyan A
胰腺癌是美国第四大最常见的癌症死亡，尽管它只占癌症病例总数的一小部分。远处转移性疾病患者的5年总生存率（OS）约为3%。新的治疗方案是一个尚未满足的需求，仍然是一个积极研究的领域。一名53岁男性转移性胰腺癌患者在接受一种新的治疗组合约24小时后出现急性慢性呼吸衰竭。胸部影像学表现为肺炎的明显改变。感染检查呈阴性。患者在接受初始静脉注射类固醇和氧支持后有初步临床改善，但最终恶化，后来选择仅支持措施。在排除感染的情况下，药物性肺炎被认为是影像学和临床改变的可能原因。在这种情况下，症状的迅速发作是一个突出的方面。
Pancreatic cancer is the fourth most common cancer death in the United States despite comprising a small percentage of the total number of cancer cases. The estimated 5-year overall survival (OS) for patients with distant metastatic disease is approximately 3%. New treatment options are an unmet need and remain an area of active investigation. A 53-year-old male with metastatic pancreatic cancer presented to the hospital with acute-on-chronic respiratory failure approximately 24 hours after receiving a novel therapeutic combination. Chest imaging showed marked changes as concerning for pneumonitis. Infectious workup was negative. The patient had initial clinical improvement after receiving initial intravenous steroids and oxygen support but eventually deteriorated later opting for supportive measures only. With infection ruled out, drug-induced pneumonitis was felt to be the likely cause of the radiologic and clinical changes. The rapidity of onset of symptoms is the aspect being highlighted in this case.