Pulmonary fibrosis and cytokine release syndrome after hyperactivation with sintilimab.

What is known and objective: Immunotherapy‐related adverse events (irAEs) are common immunotherapy‐associated diseases. Severe pulmonary fibrosis with hypercytokinaemia has not been reported with programmed cell death 1 (PD‐1) inhibitors. We describe a case of sintilimab‐induced pulmonary fibrosis with cytokine storm induced in a 50‐year‐old patient with colon cancer refractory to second‐line systemic chemotherapy. Case summary: Our patient developed hypercytokinaemia with elevated levels of interleukin (IL)‐6 and IL‐10 and pulmonary fibrosis, which differed from other irAEs. The patient benefited from a back‐titrated regimen of methylprednisolone with the initial dosage of 2 mg/kg and anti‐fibrotic effect of nintedanib and was successfully weaned from the ventilator. What is new and conclusion: This is the first report that a PD‐1 inhibitor may have caused pulmonary fibrosis and a cytokine storm. This case indicates that the addition of nintedanib and glucocorticoid might possibly have potentially therapeutic effects of PD‐1 induced pulmonary fibrosis and hypercytokinaemia. [ABSTRACT FROM AUTHOR]