Late onset of nivolumab-induced severe gastroduodenitis and cholangitis in a patient with stage IV melanoma.

Late onset of nivolumab-induced severe gastroduodenitis and cholangitis in a patient with stage IV melanoma.

Publication date: Jul 15, 2019

Antiprogramed cell death-1 protein agents represent a therapeutic approach based on stimulating the host’s immune response through blockade of immune checkpoints, inhibitory pathways that dampen the physiological peripheral T-cell immune response and are essential for maintaining self-tolerance. We describe the late onset of severe gastroduodenitis and cholangitis in a nivolumab-treated, metastatic melanoma patient in complete remission. Positron-emission tomography with computed tomography scans showed diffuse fluorodeoxyglucose (FDG) uptake in the stomach preceding upper digestive tract symptoms. Hence, positron-emission tomography with computed tomography might as well be a useful tool for early diagnosis of subclinical gastric toxicity as recently shown for colitis. Furthermore, physicians must be aware and remain vigilant to antiprogramed cell death-1 protein-related digestive toxicity that may appear very late during treatment.

Concepts Keywords
Blockade Metastatic melanoma
Cholangitis Immunotherapy
Colitis Medicine
Computed Tomography Neuroimaging
Digestive Tract Clinical medicine
FDG Medicinal radiochemistry
Fluorodeoxyglucose Medical physics
Immunotherapy Branches of biology
Melanoma Bristol-Myers Squibb
Positron Emission Tomography Radiopharmaceuticals
Protein Nivolumab
Remission Melanoma
Stomach Tomography
T Cell PET-CT
Toxicity Tomography

Semantics

Type Source Name
disease DOID gastritis
disease MESH gastritis
disease DOID duodenitis
disease MESH duodenitis
gene UNIPROT PDCD1
gene UNIPROT RPL17
disease DOID colitis
disease MESH colitis
disease MESH diagnosis
gene UNIPROT SMUG1
pathway BSID Melanoma
disease DOID melanoma
disease MESH melanoma
disease DOID cholangitis
disease MESH cholangitis
disease DOID gastroduodenitis
drug DRUGBANK Nivolumab

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