Interstitial lung disease induced by docetaxel and ramucirumab chemotherapy after nivolumab treatment.

Three men (aged 64, 65, and 67 years) with advanced lung cancer who had been treated with nivolumab developed interstitial lung disease (ILD) during chemotherapy with docetaxel and ramucirumab. The treatment was clinically effective; however, the patients experienced immune-related adverse effects due to nivolumab therapy: two patients developed ILD and the third developed psoriasis. Because the patients showed progression, docetaxel and ramucirumab chemotherapy was administered. Although two patients showed a clinical response, all patients developed grade 3 ILD during therapy. Furthermore, the patients developed respiratory failure and needed corticosteroid therapy. Although their condition improved owing to the therapy, the patients could not receive additional cancer treatment and died of cancer. On the basis of the results obtained, we speculated that although the regimen of docetaxel and ramucirumab after nivolumab therapy might be effective against non-small cell lung cancer, it might increase the risk for ILD in some patients.

Successful treatment of non-tuberculous mycobacterial pleurisy with acute fever by antimycobacterial therapy.

We report two cases of pleurisy caused by non-tuberculous mycobacteria followed by pneumothorax. The onset of pleurisy was accompanied by acute fever. Cultured samples of the pleural effusions from the two patients, an 80-year-old man and an 87-year-old woman, were ultimately found to contain Mycobacterium intracellulare and Mycobacterium kansasii, respectively. Both patients were initially administered antibiotics, but their fevers persisted. Therefore, different combinations of antimycobacterial drugs were used, which reduced the fever in a few days. In these patients, pleurisy caused by non-tuberculous mycobacteria followed by pneumothorax was characterised by acute fever and improvement in the fever after administration of antimycobacterial drugs; however, the aetiology remains to be clarified.

[A patient with primary breast cancer who responded remarkably well to neoadjuvant chemotherapy with FEC100 followed by Abraxane].

A 49-year-old woman visited our hospital presentind with a right breast lump. She underwent core needle biopsy, and her disease was diagnosed as breast cancer(invasive ductal carcinoma, ER slightly positive, PgR and HER2 negative). We chose neoadjuvant chemotherapy because the tumor size was over 3 cm in diameter with a histological grade III, and she asked to have her breast conserved. Because she had an allergy to alcohol, we treated her with FEC100 followed by Abraxane(260mg/ m2)q3W for 4 courses. After chemotherapy, she received breast conserving therapy. During the treatment with Abraxane, the patient was very well and showed no major side effects except for grade 3 neutropenia was found on an outpatient basis. After chemotherapy, breast MRI detected no invasive lesion. Pathological examination showed pCR. We concluded that Abraxane was a good option as neoadjuvant chemotherapy for early breast cancer.