ArticleExperimental and therapeutic medicine2026
Severe steroid-refractory immune checkpoint inhibitor-associated pneumonitis and exploration of potential biomarkers: A case report.
Article in Experimental and therapeutic medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Immune checkpoint inhibitor-associated pneumonitis (CIP) is a severe and potentially fatal immune-related adverse event. Its clinical management is highly challenging, especially in severe cases that are refractory to steroid therapy, making the exploration of biomarkers for assessing disease severity and predicting treatment response critically important. A 66-year-old male patient with stage IV lung adenocarcinoma developed acute fever and dyspnea after treatment with the anti-programmed cell death protein-1 inhibitor tislelizumab and was subsequently diagnosed with severe (grade 4) CIP. During the acute phase of the disease, laboratory tests revealed that the patient's peripheral blood absolute eosinophil count (AEC), interleukin-6 (IL-6) and C-reactive protein (CRP) concentrations were significantly and synchronously elevated. The patient responded poorly to initial empirical anti-infective and low-dose steroid therapy, leading to rapid clinical deterioration. After the treatment was upgraded to methylprednisolone pulse therapy (500 mg/day) combined with intravenous immunoglobulin, the condition was effectively controlled and the clinical symptoms gradually alleviated. Follow-up revealed that while CIP inflammation resolved, the underlying stage IV lung adenocarcinoma progressed, leading to the re-initiation of systemic chemotherapy in February 2025. In conclusion, dynamic changes in the combination of AEC, IL-6 and CRP may serve as biomarkers for assessing the severity, immune phenotype and treatment response of CIP. A comprehensive strategy for the successful management of severe, steroid-refractory CIP should involve early recognition, rapid pathogen exclusion via targeted next-generation sequencing and the timely escalation of immunosuppression combined with multiorgan function support. The clinical value of the aforementioned biomarkers requires further research for validation.
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