Case Report: Hepatic Sarcoid-Like Reaction Associated With Checkpoint Inhibition in a NSCLC Patient and a Literature Review

• Published in: Frontiers in oncology Vol. 12; p. 824308
• Main Authors: Lin, Yuxin, Zhu, Wei, Wu, Bingchen, Lan, Huiyin
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 10.03.2022
• Subjects: case report; immune checkpoint inhibitor; Oncology; PD-1; Sarcoid-like reaction; Toripalimab; case report; immune checkpoint inhibitor; Toripalimab; PD-1; Sarcoid-like reaction
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2022.824308

Immune checkpoint inhibitor (ICI) treatment has dramatically revolutionized the landscape of therapeutic approaches in multiple cancers, particularly, non-small-cell lung cancer (NSCLC). With the increasing use of programmed death-1 (PD-1) inhibitors in the clinic, the emerging toxicity profile presents a novel learning curve for clinicians. Here we report the first case of an NSCLC patient displaying sarcoid/granulomatous-like reaction (SLR, also known as GLR) in the liver during an anti-PD-1 therapy which showed efficacious response of complete regression. Also, this is the first report describing the SLR induced by toripalimab, a novel PD-1 inhibitor. Given this kind of hepatic findings can be easily mistaken as metastasis, even resulting in premature use of second-line treatments. In particular, we briefly review the clinical features of all those cases reporting sarcoidosis and SLRs manifested on different organs during anti-PD-(L)1 therapy. We anticipate that these clinical cases would help to alert the attention of clinicians that SLRs, as a rare immune-related adverse event (irAE), is manageable and that histopathological analysis is necessary before interpreting it as disease progression.