Patients with pericardial effusion under nivolumab: demographic and clinical characteristics
| All patients(n = 16) | Previous cases(n = 13) | This work(n = 3) | ||||
|---|---|---|---|---|---|---|
| n | % | n | % | n | ||
| Patient’s characteristics | ||||||
| Male | 12 | (75) | 11 | (86) | 1 | |
| Age (years ± SD) | 63 | ±7 | 64 | ±7 | 59 | ±4 |
| Smoker | 11 | (69) | 8 | (62) | 3 | |
| Type of tumour | ||||||
| S-NSCLC | 2 | (13) | 2 | (15) | 0 | |
| A-NSCLC | 13 | (81) | 10 | (77) | 3 | |
| SCLC | 1 | (6) | 1 | (8) | 0 | |
| Stage | ||||||
| IIIb | 4 | (25) | 4 | (31) | 0 | |
| IV | 12 | (75) | 9 | (69) | 3 | |
| Malignant pericardial effusion | 8 | (50) | 6 | (46) | 2 | |
| n-line therapy | ||||||
| 2 | 10 | (63) | 7 | (54) | 3 | |
| 3 | 3 | (19) | 3 | (23) | 0 | |
| > 3 | 2 | (13) | 2 | (15) | 0 | |
| Previous therapeutics | ||||||
| Thoracic irradiation | 10 | (63) | 7 | (54) | 3 | |
| Cisplatin | 6 | (38) | 5 | (38) | 1 | |
| Carboplatin | 11 | (69) | 9 | (69) | 2 | |
| Paclitaxel | 3 | (19) | 3 | (23) | 0 | |
| Pemetrexed | 9 | (56) | 7 | (54) | 2 | |
| Etoposide | 2 | (13) | 2 | (15) | 0 | |
| Tyrosine kinase inhibitors | 3 | (19) | 3 | (23) | 0 | |
| Bevacizumab | 3 | (19) | 3 | (23) | 0 | |
| Othersa | 5 | (31) | 4 | (31) | 1 | |
| Pericardial effusion | ||||||
| Time of onset (cycles, median (range)) | 5 | (1–35) | 5 | (1–24) | 6 | (4–35) |
| Initial symptoms | ||||||
| Dyspnea | 11 | (69) | 9 | (69) | 2 | |
| Chest pain | 3 | (19) | 3 | (23) | 0 | |
| Shock | 5 | (31) | 4 | (31) | 1 | |
| Respiratory failure | 4 | (25) | 3 | (23) | 1 | |
| Tachycardia | 5 | (31) | 5 | (38) | 0 | |
| Tamponade | 13 | (81) | 11 | (85) | 2 | |
| Asymptomatic | 2 | (13) | 1 | (8) | 1 | |
| Othersb | 3 | (19) | 2 | (15) | 1 | |
| Treatment | ||||||
| Pericardiocentesis | 11 | (69) | 10 | (77) | 1 | |
| Pericardial window | 5 | (31) | 4 | (31) | 1 | |
| Surgical drainage | 2 | (13) | 1 | (8) | 1 | |
| Corticosteroids | 7 | (44) | 5 | (38) | 2 | |
| Colchicine | 2 | (13) | 1 | (8) | 1 | |
| Nivolumab use | ||||||
| Stopped | 10 | (63) | 8 | (62) | 2 | |
| Continued | 2 | (13) | 2 | (15) | 0 | |
| Stopped and Resumed | 4 | (25) | 3 | (23) | 1 | |
| Outcome | ||||||
| Progression | 1 | (6) | 0 | (0) | 1 | |
| Pseudoprogression | 8 | (50) | 7 | (54) | 1 | |
| Resolution of pericardial effusion | 12 | (75) | 9 | (69) | 3 | |
| Other IrAEs | 7 | (44) | 5 | (38) | 2 | |
| Recurrent pericardial effusion | 3 | (19) | 3 | (23) | 0 | |
| Hypothyroiditis | 2 | (13) | 2 | (15) | 0 | |
| Colitis | 2 | (13) | 0 | (0) | 2 | |
| Pneumonitis | 1 | (6) | 1 | (8) | 0 | |
| Pericardial fluid cytology | ||||||
| Malignant cells | 6 | (38) | 6 | (46) | 0 | |
| Leukocytes | 8 | (50) | 6 | (46) | 2 | |
| Serosanguinous | 7 | (44) | 6 | (46) | 1 | |
| Pericardial biopsy | ||||||
| Malignant cells | 0 | (0) | 0 | (0) | 0 | |
| Lymphocytes | 4 | (25) | 3 | (23) | 1 | |
| Atypical cells | 2 | (13) | 1 | (8) | 1 | |
| Inflammation | 5 | (31) | 5 | (38) | 0 | |
| Fibrosis | 4 | (25) | 4 | (31) | 0 | |
| Fibrinous | 3 | (19) | 3 | (23) | 0 | |
| Mesothelial hyperplasia | 2 | (13) | 1 | (8) | 1 | |
Data are given as absolute value with percentage for all patients (n = 16), for patients from case reports reported in the literature (n = 13) and from our 3 cases
aTopotecan, Everolimus, Temozolamide, Docetaxel, Gemcitabine, Vinorelbine, S-1
bCaughing (1), Fever (1), cardiac arrest (1)