Infliximab treatment in immune-related pneumonitis with respiratory failure after high-dose steroids: A patient with metastatic gastric cancer

Abstract

Patients treated with immune checkpoint inhibitors sometimes have immune-related adverse events (IRAEs). Immune-related pneumonitis (IRP) is an uncommon but potentially fatal IRAE. We report a 69-year-old man with metastatic gastric cancer who received paclitaxel and nivolumab after failure with oxaliplatin and capecitabine. After his third dose of nivolumab, he had progressive shortness of breath and was diagnosed as having IRP with respiratory failure. He received high-dose methylprednisolone for 2 days, however, the response was not satisfactory. Thus, we added infliximab 5 mg/kg to high-dose methylprednisolone. With the combination of infliximab and high-dose methylprednisolone, the IRP greatly improved. Moreover, he had nearly complete remission of gastric cancer and was progression free for 3 months without any further anticancer treatment.