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Tuberculosis associated with triplet therapy for lung cancer

Tuberculosis associated with triplet therapy for lung cancer
Tuberculosis associated with triplet therapy for lung cancer
We report the first case of TB associated with triplet therapy (chemotherapy and immunotherapy concurrently) for lung cancer, developing just 44 days after treatment initiation. We feel that several important learning points arise from the discussion that are likely to be very relevant to the broad readership of Thorax, and have important clinical and scientific implications. In the three discussion paragraphs, we highlight that: 1) Triplet therapy is now standard first-line treatment for inoperable lung cancer. 2) TB reactivation is increasingly recognised as an adverse effect of immune checkpoint inhibition, but sending diagnostic samples is critical to avoid a missed diagnosis. 3) These insights from novel cancer immunotherapies are challenging the traditional views of the host-pathogen interaction in TB, with wide implications for future control strategies. We propose that the cases reported in the literature are likely to be the tip of the iceberg as most people with lung cancer managed with antiprogrammed death-1 agents who develop new lung lesions will be treated with standard antibiotics and then palliated when they do not respond.
lung cancer, lung cancer chemotherapy, non-small cell lung cancer, tuberculosis
0040-6376
Crawley, Danielle
d47e17b2-5da1-439a-b72b-fe910129592a
Breen, Ronan
8e338534-44de-4f74-bca7-33edd1fe6cc0
Elkington, Paul
60828c7c-3d32-47c9-9fcc-6c4c54c35a15
Karapanagiotou, Eleni
0554027b-bb33-4481-a5f7-b99f79958028
Crawley, Danielle
d47e17b2-5da1-439a-b72b-fe910129592a
Breen, Ronan
8e338534-44de-4f74-bca7-33edd1fe6cc0
Elkington, Paul
60828c7c-3d32-47c9-9fcc-6c4c54c35a15
Karapanagiotou, Eleni
0554027b-bb33-4481-a5f7-b99f79958028

Crawley, Danielle, Breen, Ronan, Elkington, Paul and Karapanagiotou, Eleni (2020) Tuberculosis associated with triplet therapy for lung cancer. Thorax, [213913]. (doi:10.1136/thoraxjnl-2019-213913).

Record type: Letter

Abstract

We report the first case of TB associated with triplet therapy (chemotherapy and immunotherapy concurrently) for lung cancer, developing just 44 days after treatment initiation. We feel that several important learning points arise from the discussion that are likely to be very relevant to the broad readership of Thorax, and have important clinical and scientific implications. In the three discussion paragraphs, we highlight that: 1) Triplet therapy is now standard first-line treatment for inoperable lung cancer. 2) TB reactivation is increasingly recognised as an adverse effect of immune checkpoint inhibition, but sending diagnostic samples is critical to avoid a missed diagnosis. 3) These insights from novel cancer immunotherapies are challenging the traditional views of the host-pathogen interaction in TB, with wide implications for future control strategies. We propose that the cases reported in the literature are likely to be the tip of the iceberg as most people with lung cancer managed with antiprogrammed death-1 agents who develop new lung lesions will be treated with standard antibiotics and then palliated when they do not respond.

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CBD_TB_triplet_accepted - Accepted Manuscript
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More information

Accepted/In Press date: 18 March 2020
e-pub ahead of print date: 14 May 2020
Keywords: lung cancer, lung cancer chemotherapy, non-small cell lung cancer, tuberculosis

Identifiers

Local EPrints ID: 441647
URI: http://eprints.soton.ac.uk/id/eprint/441647
ISSN: 0040-6376
PURE UUID: 554745c5-8075-455c-abc0-481382148640
ORCID for Paul Elkington: ORCID iD orcid.org/0000-0003-0390-0613

Catalogue record

Date deposited: 23 Jun 2020 16:30
Last modified: 26 Nov 2021 02:59

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Contributors

Author: Danielle Crawley
Author: Ronan Breen
Author: Paul Elkington ORCID iD
Author: Eleni Karapanagiotou

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