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Relapsing polychondritis after treatment with PD-1 blockade

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Summary

Nivolumab, a programmed death 1 blockade drug, is used in various types of cancers and can cause a unique immune-related adverse event (irAE). Relapsing polychondritis (RP) is a rare autoimmune disease that mainly involves inflammation of the auricle, nose and airway cartilage. A 72-year-old man with mandibular cancer received nivolumab after surgery for the primary lesion and radiation therapy for lung metastases. He then developed radiation pneumonitis, and prednisolone (PSL) was started. During the tapering of PSL, he developed exertional dyspnea and cough. The condition of mandibular cancer and radiation pneumonitis had not deteriorated. Fluorodeoxyglucose (FDG)-PET/CT showed a thickening of and abnormal FDG uptake in the tracheobronchial and nasal septum cartilage. These characteristic findings were not observed before nivolumab was initiated; thus, we clinically diagnosed the patient as having RP induced by nivolumab. Since the symptoms were mild, the patient’s condition was carefully managed with inhaled corticosteroids, and the RP has not progressed thus far. Physicians should be aware that RP can occur as an irAE because RP may progress to serious respiratory symptoms.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Tatsuya Ogimoto, Hironori Yoshida & Toyohiro Hirai

  2. Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Masanobu Mizuta

Authors
  1. Tatsuya Ogimoto
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  2. Hironori Yoshida
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  3. Masanobu Mizuta
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  4. Toyohiro Hirai
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Tatsuya Ogimoto, Hironori Yoshida, Masanobu Mizuta and Toyohiro Hirai. The first draft of the manuscript was written by Tatsuya Ogimoto and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hironori Yoshida.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ogimoto, T., Yoshida, H., Mizuta, M. et al. Relapsing polychondritis after treatment with PD-1 blockade. Invest New Drugs 40, 389–391 (2022). https://doi.org/10.1007/s10637-021-01186-3

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  • DOI: https://doi.org/10.1007/s10637-021-01186-3

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