Readministration of Pembrolizumab after Treatment of Tuberculosis Activated by Initial Pembrolizumab Therapy

Intern Med. 2021 Jun 1;60(11):1743-1746. doi: 10.2169/internalmedicine.6002-20. Epub 2020 Dec 29.

Abstract

Increasing the T-cell immune response to Mycobacterium tuberculosis with an anti-programmed cell death 1 (anti-PD-1) antibody may ultimately have detrimental effects. We present the case of a patient with advanced non-small cell lung cancer who developed active tuberculosis (TB) after initial treatment with pembrolizumab, an anti-PD-1 antibody. Pembrolizumab was resumed after completing anti-TB treatment, and no relapse of TB was observed clinically or radiologically. Checkpoint inhibitor-related pneumonitis (CIP) is first suspected when a pulmonary shadow presents during treatment with an anti-PD-1 antibody. It is sometimes difficult to diagnose CIP using computed tomographic images alone. Careful testing, including bacterial examinations and bronchoscopic biopsy, should be performed.

Keywords: Mycobacterium tuberculosis; immune checkpoint inhibitor; non-small cell lung cancer; pembrolizumab.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Lung Neoplasms* / drug therapy
  • Neoplasm Recurrence, Local
  • Programmed Cell Death 1 Receptor
  • Tuberculosis* / drug therapy

Substances

  • Antibodies, Monoclonal, Humanized
  • Programmed Cell Death 1 Receptor
  • pembrolizumab