title: Corneal graft rejection in a patient treated with nivolumab for primary lung cancer.
abstract: We report the case of a 58-year-old woman treated with nivolumab for an unresectable squamous non-small cell lung cancer, after first-line cisplatin and gemcitabine combination chemotherapy. This woman had a history of left corneal graft. After 9 cycles of nivolumab, the patient described decreased visual acuity in the left eye with watering and conjunctival erythema. Ophthalmological examination revealed chronic corneal graft rejection. The patient was then treated with an intravenous bolus of corticosteroids (500mg of methylprednisolone) for 3 days, followed by oral prednisone for 4 weeks and subconjunctival corticosteroid injections every 48h, while treatment with nivolumab was discontinued. No clinical benefit was observed 4 weeks later and the corneal graft became totally unfunctional despite of the therapy. We hypothesise that the treatment was started too late. To our knowledge, this is the first reported case of corneal graft rejection related to nivolumab.
authors.affiliation: LUNAM Université, 49 000 Angers, France; Université d'Angers, CHU Angers, Pôle des Spécialités Médicales et Chirurgicales Intégrées, Service de Pneumologie, 49 000 Angers, France. Electronic address: sophie.lefournis@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Le Fournis
authors.affiliation: LUNAM Université, 49 000 Angers, France; Université d'Angers, CHU Angers, Pôle Neurosciences Spécialités Chirurgicales, Service d'Ophtalmologie, 49 000 Angers, France. Electronic address: phgohier@chu-angers.fr.
authors.forename: P
authors.initials: P
authors.lastname: Gohier
authors.affiliation: LUNAM Université, 49 000 Angers, France; Université d'Angers, CHU Angers, Pôle des Spécialités Médicales et Chirurgicales Intégrées, Service de Pneumologie, 49 000 Angers, France; INSERM UMR_S 1066 Micro et Nanomédecines Biomimétiques, 49 000 Angers, France. Electronic address: thurban@chu-angers.fr.
authors.forename: T
authors.initials: T
authors.lastname: Urban
authors.affiliation: LUNAM Université, 49 000 Angers, France; Université d'Angers, CHU Angers, Pôle des Spécialités Médicales et Chirurgicales Intégrées, Service de Pneumologie, 49 000 Angers, France. Electronic address: thjeanfaivre@chu-angers.fr.
authors.forename: T
authors.initials: T
authors.lastname: Jeanfaivre
authors.affiliation: LUNAM Université, 49 000 Angers, France; Université d'Angers, CHU Angers, Pôle des Spécialités Médicales et Chirurgicales Intégrées, Service de Pneumologie, 49 000 Angers, France; INSERM UMR_S 1066 Micro et Nanomédecines Biomimétiques, 49 000 Angers, France. Electronic address: johureaux@chu-angers.fr.
authors.forename: J
authors.initials: J
authors.lastname: Hureaux
mesh_terms: D061605:Administration, Intravenous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D016039:Corneal Transplantation / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008775:Methylprednisolone; D008875:Middle Aged; D000077594:Nivolumab
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000077594:Nivolumab; D008775:Methylprednisolone
keywords: Graft rejection; Lung cancer; Nivolumab