Hormone inhalation stops severe side effect of immune cancer therapy
Using a novel therapeutic approach, physicians at the Medical Center - University of Freiburg succeeded in curing pneumonia in a patient that had occurred as a result of immune cancer therapy / Publication in the New England Journal of Medicine
Novel immunotherapies have become an integral part of the treatment of cancer patients. However, they also repeatedly lead to life-threatening inflammation of the lungs. Scientists and physicians at the Medical Center - University of Freiburg have now successfully used a novel therapeutic approach in a patient. The patient had received immunotherapy for melanoma, also known as black skin cancer. However, this triggered severe pneumonia. The physicians decided to give him the intestinal hormone "vasoactive intestinal peptide" (VIP) for inhalation, the use of which is being researched at the Medical Center - University of Freiburg for similar clinical pictures. Within a few weeks, the pneumonia disappeared completely, which had previously not been achieved with cortisone. The case report was published in the renowned New England Journal of Medicine on June 25, 2020.
"After the patient was initially given cortisone, shortness of breath and coughing quickly returned," reports Dr. Frank Meiß, Senior Consultant in the Department of Dermatology and Venereology at the Medical Center - University of Freiburg. Together with the patient, it was therefore decided to take a new approach and give him VIP for inhalation.
The physicians and scientists in Freiburg came up with the idea of administering VIP because they were investigating new therapeutic approaches for the lung disease sarcoidosis in several research projects and had already achieved initial success with VIP. "We opted for this experimental therapy because there are similarities between sarcoidosis and this type of non-bacterial pneumonia," says Dr. Björn Christian Frye, senior physician at the Department of Pneumology at the Medical Center - University of Freiburg.
"We had expected the pneumonia to improve, but were very positively surprised by the success of the therapy. The inflammation subsided and the patient's shortness of breath disappeared," says Prof. Dr. Joachim Müller-Quernheim, Medical Director of the Department of Pneumology at the Medical Center - University of Freiburg. This type of non-bacterial pneumonia, known as pneumonitis, occurs in 10 to 20 percent of all patients with immune cancer therapy and is usually treated with steroids such as cortisone. However, these sometimes have severe side effects and require immunotherapy to be discontinued. Instead of cortisone tablets, which only led to short-term improvement but also side effects, the patient only had to inhale three times a day. No side effects occurred during the VIP therapy.
In the next step, the Freiburg team is planning a larger clinical trial to clarify whether and for which cancer patients with pneumonitis the therapy approach could be considered.
Original title of the publication: Vasoactive Intestinal Peptide in Checkpoint Inhibitor-Induced Pneumonitis
DOI: 10.1056/NEJMc2000343
Link to the study:https://www.nejm.org/doi/10.1056/NEJMc2000343
Contact:
Prof. Dr. Joachim Müller-Quernheim
Medical Director
Department of Pneumology
Medical Center - University of Freiburg
Phone: 0761 270-37060
joachim.mueller-quernheim@uniklinik-freiburg.de
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