Work

Resolution of Corticosteroid Refractory Checkpoint Inhibitor–Induced Pneumonitis With Tocilizumab and Mycophenolate Mofetil Therapy

Year: 2025

Type: article

Abstract: A 69-year-old woman with metastatic esophageal cancer, undergoing treatment with FOLFOX (folinic acid, fluorouracil, and oxaliplatin), pembrolizumab, and trastuzumab, developed fever and hypoxemia following her fourth treatment cycle. Clinical presentation and radiographic findings confirmed a diagnosis of immune-related pneumonitis. Her condition deteriorated despite high-dose glucocorticoid therapy, necessitating intensive care unit management. Administration of tocilizumab and mycophenolate mofetil resulted in a dramatic improvement within 48 hours, leading to extubation and eventual hospital discharge. This case underscores the critical role of intensified immunosuppressive therapy for managing steroid-refractory pneumonitis and highlights tocilizumab as a potential agent to reduce mortality in this challenging clinical scenario.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2024.1326

Authors: Juan Jose Juarez-Vignon Whaley, Soravis Osataphan, Matthew Koomey, Mary Linton Peters

Institutions: Beth Israel Deaconess Medical Center, Harvard University, Beth Israel Deaconess Hospital

Language: English

Topic: Cancer Immunotherapy and Biomarkers

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4412983005

FWCI:

Cites: 14

Cited by:

Related to: 10