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The meaning of lymphadenopathies during adjuvant durvalumab after chemoradiotherapy for lung cancer: thinking beyond disease progression

2022-07Journal article Open access
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dc.contributor.authorPantarotto, Marcos
dc.contributor.authorBarata, Rita
dc.contributor.authorCoelho, Ricardo
dc.contributor.authorCarvalheiro, Catarina
dc.contributor.authorRolim, Ines
dc.contributor.authorGarrido, Patricia
dc.contributor.authorGIl, Nuno
dc.contributor.authorDuarte-Ramos, Filipa
dc.contributor.authorTonin, Fernanda
dc.date.accessioned2022-07-19T16:56:28Z
dc.date.available2022-07-19T16:56:28Z
dc.date.issued2022-07
dc.description.abstractImmune-checkpoint inhibitors (ICIs) have become the mainstay of treatment for many malignancies. With this new strategy, relevant immune-related adverse events (irAEs) have been reported, some of which can be mistaken for disease progression. To better illustrate the current challenges in diagnosing and managing a patient under adjuvant ICI treatment, we present the case of a 67-year-old female patient with stage IIIB unresectable, epidermal growth factor receptor (EGFR)-mutated, non-small-cell lung cancer who was initially treated with chemoradiotherapy, followed by immunotherapy with durvalumab. During the course of immunotherapy, the patient presented with madarosis and erythematous and endured skin lesions, in addition to lymphadenopathies and pulmonary infiltrates. She was started on first-line palliative treatment with an EGFR tyrosine kinase inhibitor. After reviewing the case, a multidisciplinary team meeting suggested diagnostic procedures, including a transbronchial needle aspiration from mediastinal lymph nodes. The histologic examination showed chronic systemic inflammation and non-caseating granulomas of the sarcoid type. In this case, palliative treatment was suspended and systemic therapy with prednisolone was initiated. The patient became asymptomatic and the previously observed radiologic abnormalities resolved. This case highlights the importance of early recognition and appropriate treatment of irAEs, mainly because these conditions remain poorly understood and are probably underdiagnosed. Considering differential diagnosis is paramount to guide clinical management, despite curative or palliative treatment intent.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPantarotto M, Barata R, Coelho R, Cavalheiro C, Rolim I, Tonin FS, et al. The meaning of lymphadenopathies during adjuvant durvalumab after chemoradiotherapy for lung cancer: thinking beyond disease progression. Cureus. 2022;14(7):e26729.pt_PT
dc.identifier.doi10.7759/cureus.26729pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/14844
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.publisherversionhttps://www.cureus.com/articles/98971-the-meaning-of-lymphadenopathies-during-adjuvant-durvalumab-after-chemoradiotherapy-for-lung-cancer-thinking-beyond-disease-progressionpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectImmune-checkpoint inhibitorspt_PT
dc.subjectPseudoprogressionpt_PT
dc.subjectImmune-related adverse eventspt_PT
dc.subjectLung cancerpt_PT
dc.subjectDifferential diagnosispt_PT
dc.titleThe meaning of lymphadenopathies during adjuvant durvalumab after chemoradiotherapy for lung cancer: thinking beyond disease progressionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue7pt_PT
oaire.citation.startPagee26729pt_PT
oaire.citation.titleCureuspt_PT
oaire.citation.volume14pt_PT
person.familyNameTonin
person.givenNameFernanda
person.identifier.ciencia-idD01C-C700-9411
person.identifier.orcid0000-0003-4262-8608
person.identifier.ridO-2050-2017
person.identifier.scopus-author-id56085115800
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication61ded30e-ecec-4b3e-b953-2293e080ebdd
relation.isAuthorOfPublication.latestForDiscovery61ded30e-ecec-4b3e-b953-2293e080ebdd

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