Sarcoid-like granulomatosis in cancer patients treated with immune checkpoints inhibitors

Introduction. - Immune checkpoint inhibitors are becoming a standard treatment for many different cancers. Their toxicities are variable and include organ-specific dysimmune injuries and the development of systemic diseases. Case report. - We report 3 cases of sarcoid-like granulomatosis that occurred during treatment of various types of primary cancer by immune checkpoint inhibitors: lung adenocarcinoma, small cell lung cancer and melanoma. The clinical presentation, radiologic pattern and severity of this toxicity were variable. The diagnosis was made on biopsy with pathological examination and exclusion of differential diagnoses, particularly infection. In such cases, immunotherapy should be discontinued and subsequent rechallenge discussed later. Systemic corticosteroids should be considered depending on the severity of symptoms. Conclusions. - Knowledge of this toxicity is crucial as the clinical signs and radiological patterns may suggest tumour progression. (C) 2018 SPLF. Published by Elsevier Masson SAS. All rights reserved.