Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

First case of DLBCL secondary to nivolumab treatment for NSCLC reported

Key clinical point: Immune checkpoint inhibitor-induced lymphomas are rare and no safety signal has been raised.

Major finding: A spleen biopsy revealed a germinal center, centroblastic variant of DLBCL, stage I.

Study details: PET scan plus spleen biopsy of 60 year-old man receiving nivolumab for NSCLC.

Disclosures: The authors reported receiving fees from various pharmaceutical companies.

Commentary

“Checkpoint inhibitors have significantly improved outcomes in multiple cancer types with historically poor prognoses including non-small cell lung cancer (NSCLC). These drugs are associated with immune-related adverse events. Drs. Boudou-Rouquette et al report a case of a 60-year old man with NSCLC who was diagnosed with diffuse large B-cell lymphoma about 2 years after completing a course of nivolumab as fourth line treatment for metastatic disease. In a review of the WHO pharmacovigilance database, the authors found 0.1% cases of lymphoma in patients who had received nivolumab, pembrolizumab, or ipilimumab. The development of lymphoma in this context is a rare phenomenon.”

Sarah Rutherford, MD

Assistant Professor of Medicine, Weill Cornell Medicine

Disclosure: Dr. Rutherford has served as a consultant to Bristol-Myers Squibb.

Citation:

Boudou-Rouquette P et al. Eur J Cancer. 2020; doi.org/10.1016/j.ejca.2020.02.006.