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Nivolumab-induced diffuse type 2 rhinosinusitis: A case report.

Firas Kassem1,2, Yossi Rosman2,3, Ilan Blau1,2

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Nivolumab treatment for advanced cancers may trigger eosinophilic airway inflammation, causing symptoms like nasal congestion and loss of smell. Physicians should monitor for this immune-related adverse event.

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Area of Science:

  • Immunology
  • Oncology
  • Otorhinolaryngology

Background:

  • Nivolumab, an immune checkpoint inhibitor, treats advanced metastatic malignancies.
  • Nivolumab can exacerbate T-Helper 2 cell responses, potentially causing airway inflammation.

Purpose of the Study:

  • To document upper airway manifestations in a patient receiving nivolumab.
  • To highlight potential immune-related adverse effects of nivolumab on the respiratory system.

Main Methods:

  • A case report detailing the clinical presentation and diagnostic findings.
  • Fiberoptic endoscopy and histopathological examination were utilized.

Main Results:

  • A 69-year-old woman developed rhinosinusitis symptoms after one year of nivolumab therapy.
  • Nasal polyps, increased eosinophil counts, and eosinophilic tissue infiltration were observed.

Conclusions:

  • Nivolumab has a generally favorable safety profile for cancer treatment.
  • Physicians should be vigilant for type II inflammation as a nivolumab side effect.
  • Prompt diagnosis and management can improve patient quality of life.