Interstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature review
Abstract Background Upper tract urothelial carcinoma (UTUC) is a rare subtype of urothelial cancer, accounting for only 5–10% of cases, and is characterized by aggressive biological behavior. Recent advances in immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) have expanded the...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12890-025-03838-z |
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| author | Peng Ding Huanhuan Lin Kaichen Zhang Qian Yang Peiyang Gao |
| author_facet | Peng Ding Huanhuan Lin Kaichen Zhang Qian Yang Peiyang Gao |
| author_sort | Peng Ding |
| collection | DOAJ |
| description | Abstract Background Upper tract urothelial carcinoma (UTUC) is a rare subtype of urothelial cancer, accounting for only 5–10% of cases, and is characterized by aggressive biological behavior. Recent advances in immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) have expanded therapeutic options for advanced UTUC. However, their combined use may increase the risk of immune-related adverse events, particularly interstitial lung disease (ILD). Case presentation This case involves a 76-year-old female patient diagnosed with UTUC. The patient was diagnosed with invasive high-grade urothelial carcinoma of the right kidney following a biopsy, after a routine physical examination revealed a space-occupying lesion in the right kidney. Due to the patient’s and her family’s refusal of surgical treatment, a targeted immunotherapy regimen combining ICIs and ADCs was chosen. After two treatments with toripalimab combined with vedotin, the patient developed clinical symptoms such as drowsiness and shortness of breath, and was diagnosed with severe pneumonia complicated by type I respiratory failure. While initial treatment with anti-infectives and glucocorticoids (methylprednisolone sodium succinate) led to some improvement, the patient’s condition rapidly deteriorated upon the discontinuation of the glucocorticoid. Given the patient’s history of immunotherapy and the worsening of her condition after the discontinuation of hormone therapy, the patient was ultimately considered to have developed immune-related lung disease (ILD) caused by toripalimab. With high-dose glucocorticoid pulse therapy and other supportive treatments, the patient’s condition was controlled and gradually stabilized, and she was subsequently discharged in stable condition. During the follow-up period, the patient continued vedotin treatment, without experiencing any significant adverse reactions. Conclusion Although the combination of toripalimab and disitamab vedotin demonstrates efficacy in treating UTUC, it may also induce severe ILD. In clinical practice, it is essential to strictly adhere to indications, enhance monitoring and follow-up, and formulate individualized treatment decisions. |
| format | Article |
| id | doaj-art-e5e92cc331d6494180efebc932a1bd5c |
| institution | Kabale University |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Pulmonary Medicine |
| spelling | doaj-art-e5e92cc331d6494180efebc932a1bd5c2025-08-20T03:42:43ZengBMCBMC Pulmonary Medicine1471-24662025-07-012511810.1186/s12890-025-03838-zInterstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature reviewPeng Ding0Huanhuan Lin1Kaichen Zhang2Qian Yang3Peiyang Gao4Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese MedicineChengdu University of Traditional Chinese MedicineDepartment of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese MedicineChengdu University of Traditional Chinese MedicineDepartment of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese MedicineAbstract Background Upper tract urothelial carcinoma (UTUC) is a rare subtype of urothelial cancer, accounting for only 5–10% of cases, and is characterized by aggressive biological behavior. Recent advances in immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) have expanded therapeutic options for advanced UTUC. However, their combined use may increase the risk of immune-related adverse events, particularly interstitial lung disease (ILD). Case presentation This case involves a 76-year-old female patient diagnosed with UTUC. The patient was diagnosed with invasive high-grade urothelial carcinoma of the right kidney following a biopsy, after a routine physical examination revealed a space-occupying lesion in the right kidney. Due to the patient’s and her family’s refusal of surgical treatment, a targeted immunotherapy regimen combining ICIs and ADCs was chosen. After two treatments with toripalimab combined with vedotin, the patient developed clinical symptoms such as drowsiness and shortness of breath, and was diagnosed with severe pneumonia complicated by type I respiratory failure. While initial treatment with anti-infectives and glucocorticoids (methylprednisolone sodium succinate) led to some improvement, the patient’s condition rapidly deteriorated upon the discontinuation of the glucocorticoid. Given the patient’s history of immunotherapy and the worsening of her condition after the discontinuation of hormone therapy, the patient was ultimately considered to have developed immune-related lung disease (ILD) caused by toripalimab. With high-dose glucocorticoid pulse therapy and other supportive treatments, the patient’s condition was controlled and gradually stabilized, and she was subsequently discharged in stable condition. During the follow-up period, the patient continued vedotin treatment, without experiencing any significant adverse reactions. Conclusion Although the combination of toripalimab and disitamab vedotin demonstrates efficacy in treating UTUC, it may also induce severe ILD. In clinical practice, it is essential to strictly adhere to indications, enhance monitoring and follow-up, and formulate individualized treatment decisions.https://doi.org/10.1186/s12890-025-03838-zToripalimabDisitamab VedotinInterstitial lung diseaseUpper tract urothelial carcinomaGlucocorticoidCase report |
| spellingShingle | Peng Ding Huanhuan Lin Kaichen Zhang Qian Yang Peiyang Gao Interstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature review BMC Pulmonary Medicine Toripalimab Disitamab Vedotin Interstitial lung disease Upper tract urothelial carcinoma Glucocorticoid Case report |
| title | Interstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature review |
| title_full | Interstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature review |
| title_fullStr | Interstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature review |
| title_full_unstemmed | Interstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature review |
| title_short | Interstitial lung disease induced by Toripalimab combined with disitamab Vedotin in upper tract urothelial carcinoma: a case report and literature review |
| title_sort | interstitial lung disease induced by toripalimab combined with disitamab vedotin in upper tract urothelial carcinoma a case report and literature review |
| topic | Toripalimab Disitamab Vedotin Interstitial lung disease Upper tract urothelial carcinoma Glucocorticoid Case report |
| url | https://doi.org/10.1186/s12890-025-03838-z |
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