Granulation tissue-induced pseudo-relapse during nivolumab treatment in advanced non-small cell lung cancer

Chihiro Ando, Eiki Ichihara, Hirohisa Kano, Yoshitaka Iwamoto, Atsuko Hirabae, Takamasa Nakasuka, Yoshinobu Maeda, Katsuyuki Kiura

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1 Citation (Scopus)


Atypical tumor responses such as pseudo-progression or hyper-progression sometimes occur during immune check point inhibitor therapy. Distinct from both responses, we experienced a case of non-small cell lung cancer (NSCLC) with a pseudo-relapse, in which development of granulation mimicked cancer relapse during nivolumab therapy. A male with advanced NSCLC started nivolumab as a second-line therapy. After 15 cycles of nivolumab with a complete response, tumor markers started increasing and positron-emission computed tomography indicated a hot spot in the sigmoid colon. Laparoscopic segmental sigmoid colon resection revealed granulation tissue without any relapse of malignant cells. The results showed that even if radiographical tumor progression is found during immune therapy, histological confirmation should be considered.

Original languageEnglish
Pages (from-to)2113-2115
Number of pages3
JournalIn Vivo
Issue number6
Publication statusPublished - Jan 1 2019



  • Granulation tissue
  • Immune checkpoint inhibitors
  • Lung cancer
  • Nivolumab

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Pharmacology

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