小腸転移からの出血によりnivolumabの継続が困難となった肺腺扁平上皮癌

Lung Adenosquamous Cell Carcinoma in which the Administration of Nivolumab Became Untenable due to Bleeding from Small Intestine Metastasis

免疫チェックポイント阻害薬であるnivolumabは，非小細胞肺癌の治療薬として承認されてから使用頻度が増加している．われわれは肺腺扁平上皮癌の術後再発に対してnivolumabを使用して効果を認めていたが，小腸転移からの出血のためnivolumabの継続が困難となった1例を経験したので，文献的考察を加えて報告する．

A 59-year-old man who had postoperative recurrence of lung adenosquamous cell carcinoma was administered nivolumab as 3rd-line chemotherapy. Although nivolumab was considered effective, bleeding from a metastatic lesion at the jejunum was recognized by double-balloon enteroscopy, and partial resection was performed. Although the re-administration of nivolumab was planned, the patient died of acute respiratory failure 6 days postoperatively.