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Immune checkpoint inhibitors (ICIs) are indispensable agents that may improve the long-term prognosis of non-small cell lung cancer. However, clinicians should always be aware that its immune-modulating mechanism of action may lead to unexpected immune-related adverse events (irAE). We report here a case of a 72-year-old man with adenocarcinoma of the lung who achieved a complete response to nivolumab plus ipilimumab plus chemotherapy but also suffered from a variety of immune-related adverse events. In this patient, Th1 immunity, which is involved in antitumor immunity, and Th2 immunity were activated, resulting in allergy-related reactions, including increased airway hyperresponsiveness and a marked increase in serum IgE levels. After starting corticosteroids, the allergic symptoms were well controlled. Remarkably, despite discontinuing ICI treatment, the patient has maintained a complete response for 27 months. Fortunately, we obtained lung and lymph node tissues from this patient after ICI administration and histologically examined the Th1 and Th2 immune status.
Nakashima et al. (Sun,) studied this question.