Tuberculosis Infection in a Patient with Lung Cancer under PD-L1 Inhibition: A Case Report

Background: Immune checkpoint inhibitors have made a great novelty in the treatment of various cancer types, showing favourable outcomes and good tolerance by cancer patients. Immune checkpoint inhibitors enhance and promote anti-tumor immunity, which can result in a wide range of adverse events, termed as immune-related adverse events, which are characterized by excessive immunity response. Although immune related adverse events are not considered to be originated from infectious causes, cases of cancer patients developing active tuberculosis during treatment with immune checkpoint inhibitors have been reported. Aim: The aim of the current case report is to highlight the importance of including opportunistic infections, such as tuberculosis, in the differential diagnosis of complications in the treatment of cancer patients receiving immunotherapy. Case presentation: This case report describes a 62-year-old Caucasian male patient who developed active pulmonary tuberculosis after treatment with Durvalumab, an anti-programmed death cell ligand-1 antibody, administered as therapy for non small cell lung cancer. The diagnosis was challenging because of the fact that the clinical presentation and the radiographic imaging were compatible with disease progression. Conclusion: Screening for active or latent tuberculosis should be part of everyday practice before the initial administration of immunotherapy in oncologic patients.