Relapsed Myasthenia Gravis after Nivolumab Treatment

Nivolumab is a newly introduced promising therapy for treating lung cancer that restores the anti-tumor immunity by disrupting programmed cell death-1-mediated immuno-suppressive signaling. Although "new-onset" autoimmune diseases are well-known immune-related adverse events, whether or no...

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Bibliographic Details
Published in:Internal Medicine 2018/07/01, Vol.57(13), pp.1893-1897
Main Authors: Mitsune, Ayumi, Yanagisawa, Satoru, Fukuhara, Tatsuro, Miyauchi, Eisaku, Morita, Mami, Ono, Manabu, Tojo, Yutaka, Ichinose, Masakazu
Format: Article
Language:English
Subjects:
anti-programmed cell death (PD) -1 monoclonal antibody
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal - therapeutic use
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Apoptosis
autoimmune disease
Autoimmune diseases
Case Report
Cell death
Disruption
Family medical history
Female
Humans
immune-related adverse events (irAEs)
Internal medicine
Lung cancer
Lung Neoplasms - drug therapy
Lung Neoplasms - pathology
Medical treatment
Middle Aged
Monoclonal antibodies
Myasthenia
Myasthenia gravis
myasthenia gravis (MG)
Myasthenia Gravis - chemically induced
Neuromuscular junctions
Nivolumab
non-small cell lung cancer
Patients
PD-1 protein
Targeted cancer therapy
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Summary:Nivolumab is a newly introduced promising therapy for treating lung cancer that restores the anti-tumor immunity by disrupting programmed cell death-1-mediated immuno-suppressive signaling. Although "new-onset" autoimmune diseases are well-known immune-related adverse events, whether or not nivolumab exacerbates "pre-existing" autoimmune disease remains unclear. We herein report a patient with "pre-existing" myasthenia gravis in whom nivolumab was administered that flared up after the treatment with nivolumab. Regardless of the disease stability, nivolumab has the potential to exacerbate an autoimmune disease, and we must pay close attention to each patient's medical history before administering this agent.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9153-17