Severe cytokine release syndrome in a patient receiving PD-1-directed therapy

Pediatr Blood Cancer. 2017 Dec;64(12). doi: 10.1002/pbc.26642. Epub 2017 May 24.

Abstract

Cytokine release syndrome (CRS) is a phenomenon of immune hyperactivation described in the setting of cellular and bispecific T-cell engaging immunotherapy. Checkpoint blockade using anti-programmed cell death 1 (anti-PD-1) inhibitors is an approach to antitumor immune system stimulation. A 29-year-old female with alveolar soft part sarcoma developed severe CRS after treatment with anti-PD-1 therapy. CRS was characterized by high fevers, encephalopathy, hypotension, hypoxia, hepatic dysfunction, and evidence of coagulopathy, and resolved after infusion of the interleukin-6 inhibitor tocilizumab and corticosteroids.

Keywords: IL-6; PD-1 inhibitor; cytokine release syndrome; nivolumab; tocilizumab.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • B7-H1 Antigen / antagonists & inhibitors*
  • Cytokines / metabolism*
  • Female
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / drug therapy*
  • Pulmonary Alveoli
  • Sarcoma / complications
  • Sarcoma / drug therapy*
  • Syndrome

Substances

  • B7-H1 Antigen
  • Cytokines