Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature review

The etoposide-carboplatin and anti-PD-L1 combination has become the standard-of-care for patients with extensive-stage small cell lung cancer (ES-SCLC). This combinational strategy is well tolerated with manageable immune-related adverse effects (irAEs). In this report, we presented a rare immediate...

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Main Authors: Guoxin Wang, MD, Wenjie Yan, MD, Jun Cai, MD, Fang Zhang, MD, Tangfeng Lv, MD, Mingxiang Ye, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325000743
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author Guoxin Wang, MD
Wenjie Yan, MD
Jun Cai, MD
Fang Zhang, MD
Tangfeng Lv, MD
Mingxiang Ye, MD, PhD
author_facet Guoxin Wang, MD
Wenjie Yan, MD
Jun Cai, MD
Fang Zhang, MD
Tangfeng Lv, MD
Mingxiang Ye, MD, PhD
author_sort Guoxin Wang, MD
collection DOAJ
description The etoposide-carboplatin and anti-PD-L1 combination has become the standard-of-care for patients with extensive-stage small cell lung cancer (ES-SCLC). This combinational strategy is well tolerated with manageable immune-related adverse effects (irAEs). In this report, we presented a rare immediate irAE after one course of anti-tumor treatment. The patient with ES-SCLC was treated with first-line etoposide-carboplatin chemotherapy and Durvalumab immunotherapy. After one cycle of indicated treatment, the patient developed persistent high-grade fever with extensive consolidation, surrounding by ground glass opacifications. The lesions did not respond to empirical antibiotics and the results for pathogen testing were negative. Histological analysis of biopsy sample yielded organizing pneumonia that was very likely to associate with Durvalumab treatment. The patient was therefore treated with prednisolone that resulted in a rapid radiological improvement. The reporting of this case is imperative for informing acute onset of irAE in patients with ES-SCLC treated with anti-PD-L1 immunotherapy. Differential diagnosis of infection, tumor progression and exacerbation of underlying illness should be considered before the initiation of prednisolone therapy.
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publishDate 2025-05-01
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series Radiology Case Reports
spelling doaj-art-28998917cfda47ce8727d1194fa1c9692025-08-20T02:59:18ZengElsevierRadiology Case Reports1930-04332025-05-012052253225710.1016/j.radcr.2025.01.072Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature reviewGuoxin Wang, MD0Wenjie Yan, MD1Jun Cai, MD2Fang Zhang, MD3Tangfeng Lv, MD4Mingxiang Ye, MD, PhD5Department of Respiratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of Respiratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of Radiology, Medical Imaging Center, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of Respiratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of Respiratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaDepartment of Respiratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China; Corresponding author.The etoposide-carboplatin and anti-PD-L1 combination has become the standard-of-care for patients with extensive-stage small cell lung cancer (ES-SCLC). This combinational strategy is well tolerated with manageable immune-related adverse effects (irAEs). In this report, we presented a rare immediate irAE after one course of anti-tumor treatment. The patient with ES-SCLC was treated with first-line etoposide-carboplatin chemotherapy and Durvalumab immunotherapy. After one cycle of indicated treatment, the patient developed persistent high-grade fever with extensive consolidation, surrounding by ground glass opacifications. The lesions did not respond to empirical antibiotics and the results for pathogen testing were negative. Histological analysis of biopsy sample yielded organizing pneumonia that was very likely to associate with Durvalumab treatment. The patient was therefore treated with prednisolone that resulted in a rapid radiological improvement. The reporting of this case is imperative for informing acute onset of irAE in patients with ES-SCLC treated with anti-PD-L1 immunotherapy. Differential diagnosis of infection, tumor progression and exacerbation of underlying illness should be considered before the initiation of prednisolone therapy.http://www.sciencedirect.com/science/article/pii/S1930043325000743Extensive-stage small cell lung cancerAnti-PD-L1 immunotherapyImmune-related adverse effectsOrganizing pneumoniaGround glass opacifications
spellingShingle Guoxin Wang, MD
Wenjie Yan, MD
Jun Cai, MD
Fang Zhang, MD
Tangfeng Lv, MD
Mingxiang Ye, MD, PhD
Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature review
Radiology Case Reports
Extensive-stage small cell lung cancer
Anti-PD-L1 immunotherapy
Immune-related adverse effects
Organizing pneumonia
Ground glass opacifications
title Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature review
title_full Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature review
title_fullStr Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature review
title_full_unstemmed Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature review
title_short Durvalumab-induced organizing pneumonia in extensive-stage small cell lung cancer: A case report and literature review
title_sort durvalumab induced organizing pneumonia in extensive stage small cell lung cancer a case report and literature review
topic Extensive-stage small cell lung cancer
Anti-PD-L1 immunotherapy
Immune-related adverse effects
Organizing pneumonia
Ground glass opacifications
url http://www.sciencedirect.com/science/article/pii/S1930043325000743
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