Journal
INTERNAL MEDICINE
Volume 61, Issue 7, Pages 1039-1042Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.6811-20
Keywords
pembrolizumab; lung cancer; tuberculosis; adverse event; immune checkpoint inhibitor
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This report demonstrates the concurrent use of immune checkpoint inhibitor and anti-TB treatment in limited TB infection area.
A 68-year-old Japanese man was diagnosed with lung adenocarcinoma stage IVB. We introduced a firstline chemotherapy of four cycles of carboplatin and pemetrexed and pembrolizumab, followed by pemetrexed and pembrolizumab maintenance therapy. Approximately four months after anticancer therapy, a small nodule appeared in the right peripheral S3 lesion. After five months, the nodule was confirmed as a Mycobacterium tuberculosis (TB) nodule. We initiated anti-TB therapy without stopping pembrolizumab, and the right S3 nodule shrank immediately. This report supports the concurrent use of anti-TB treatment with an immune checkpoint inhibitor when the TB infection area is limited.
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