Immune-related Colitis Induced by the Long-term Use of Nivolumab in a Patient with Non-small Cell Lung Cancer

Yuichiro Yasuda; Yoshiko Urata; Rie Tohnai; Shoichi Ito; Yoshitaka Kawa; Yuko Kono; Yoshihiro Hattori; Masahiro Tsuda; Toshiko Sakuma; Shunichi Negoro; Miyako Satouchi

doi:10.2169/internalmedicine.9230-17

CASE REPORTS

Immune-related Colitis Induced by the Long-term Use of Nivolumab in a Patient with Non-small Cell Lung Cancer

Yuichiro Yasuda, Yoshiko Urata, Rie Tohnai, Shoichi Ito, Yoshitaka Kawa, Yuko Kono, Yoshihiro Hattori, Masahiro Tsuda, Toshiko Sakuma, Shunichi Negoro, Miyako Satouchi

Author information

Yuichiro Yasuda
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Yoshiko Urata
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Rie Tohnai
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Shoichi Ito
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Yoshitaka Kawa
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Yuko Kono
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Yoshihiro Hattori
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Masahiro Tsuda
Department of Gastroenterological Oncology, Hyogo Cancer Center, Japan
Toshiko Sakuma
Department of Diagnostic Pathology, Hyogo Cancer Center, Japan
Shunichi Negoro
Department of Thoracic Oncology, Hyogo Cancer Center, Japan
Miyako Satouchi
Department of Thoracic Oncology, Hyogo Cancer Center, Japan

Keywords: nivolumab, immune-related adverse event, colitis, non-small cell lung cancer, immune-checkpoint-inhibitor

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 9 Pages 1269-1272

DOI https://doi.org/10.2169/internalmedicine.9230-17

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Abstract

We herein report a case of immune-related colitis induced by the long-term use of nivolumab. A 62-year-old Japanese man was treated with nivolumab at 3 mg/kg every 2 weeks for advanced lung adenocarcinoma. The patient was admitted to our hospital due to non-bloody watery diarrhea after the 70th dose of nivolumab. A biopsy specimen of the colon mucosa revealed evidence of colitis with cryptitis and crypt microabscesses. He was diagnosed with immune-related colitis and started on predonisolone 60 mg/day. Subsequently, his symptoms remarkably resolved. Consideration of immune-related adverse events up to several years after the initiation of nivolumab is important.

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