Rapid effects of benralizumab on severe asthma during surgery for residual tumor after advanced lung adenocarcinoma treatment with pembrolizumab

Publication date: Available online 19 February 2019Source: Respiratory Medicine Case ReportsAuthor(s): Takehiro Izumo, Yuriko Terada, Mari Tone, Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Atsuko Moriya, Tatsunori Jo, Hanako Yoshimura, Yoshiaki FuruhataAbstractSevere bronchial asthma is a chronic disorder of the airways that may be accompanied by comorbid diseases. Invasive treatment, including surgery, in patients with severe asthma has limitations depending on the degree of control of the asthma. A 71-year-old woman was diagnosed with adenocarcinoma with high programmed death-ligand 1 (PD-L1) expression and cT3N0M1a. After 13 cycles of pembrolizumab every 3 weeks, chest computed tomography (CT) revealed a dramatic decrease in the lesion size in the left upper lobe, but the size of the lesion in the right lower lobe was significantly increased. The pathological findings of the right residual tumor by CT-guided transthoracic needle biopsy (CTNB) revealed adenocarcinoma with no PD-L1 expression, and right lower lobectomy was recommended. However, because the patient had frequent asthma attacks and cough, surgery was considered risky. Increased blood eosinophil count was observed, and benralizumab was administered for asthma control. The symptoms disappeared 2 days after benralizumab administration, and peak flow increased. Surgery was performed 5 days after benralizumab administration. There was a marked reduction in the eosinophil count of the surgical tissue compared with ...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research