Severe mediastinitis over a month after endobronchial ultrasound‐guided transbronchial needle aspiration

Although endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) has been reported to be a minimally invasive and relatively safe procedure, mediastinitis is a serious complication related to the procedure. The median time of mediastinitis onset is approximately 12 days after EBUS‐TBNA. Here we report two rare cases with mediastinitis onset 40 and 53 days after EBUS‐TBNA. Surgical drainage was performed since systemic treatment with antibiotics was insufficient in both cases. Eikenella corrodens, which is a slow‐growing microorganism, was identified as the causative pathogen in one case. To our knowledge, this is the first report of mediastinitis occurring over a month after EBUS‐TBNA. Clinicians should consider the diagnosis of mediastinitis even if symptoms appear over a month after EBUS‐TBNA

Early Detection of Therapeutic Benefit from PD-1/PD-L1 Blockade in Advanced Lung Cancer by Monitoring Cachexia-Related Circulating Cytokines

Cancer cachexia is associated with poor immunotherapeutic outcomes. This prospective observational study longitudinally evaluated the role of cachexia-related circulating cytokines in predicting the risk and benefit of PD-1/PD-L1 blockade in advanced lung cancer. Forty-one circulating cytokines at baseline and after one cycle of PD-1/PD-L1 blockade treatment were measured in patients with advanced lung cancer between 2019 and 2020. The cachexia-related cytokines were identified by comparing the levels of circulating cytokines between cachectic and non-cachectic patients. Among 55 patients, 49.1% were diagnosed with cachexia at the beginning of PD-1/PD-L1 blockade therapy. Baseline levels of the circulating cytokines IL-6, IL-8, IL-10, IL-15, and IP-10 were significantly higher in cachectic patients. In contrast, the level of eotaxin-1 was lower in cachectic patients than in those without cachexia. Higher IL-6 at baseline and during treatment was associated with a greater risk of immune-related adverse events, while higher IL-10 at baseline was linked to worse overall survival. More importantly, increased eotaxin-1 after one cycle of PD-1/PD-L1 blockade treatment was associated with higher objective response and better overall survival. A blood-based, cachexia-related cytokine assay may yield potential biomarkers for the early prediction of clinical response to PD-1/PD-L1 blockade and provide clues for improving the outcomes of cachectic patients

Additional file 3 of Association between the efficacy and immune-related adverse events of pembrolizumab and chemotherapy in non-small cell lung cancer patients: a retrospective study

Additional file 3: Supplementary figure S2. Severe irAEs and efficacy. Kaplan–Meier curves for progression-free survival in patients with irAEs of grade 3 or higher versus patients without irAEs

Additional file 1 of Association between the efficacy and immune-related adverse events of pembrolizumab and chemotherapy in non-small cell lung cancer patients: a retrospective study

Additional file 1: Supplementary Table S1. Univariable and multivariable time-varying Cox model analysis of covariates for progression-free survival in the combination therapy and monotherapy groups

Additional file 2 of Association between the efficacy and immune-related adverse events of pembrolizumab and chemotherapy in non-small cell lung cancer patients: a retrospective study

Additional file 2: Supplementary figure S1. IrAEs and survival. Kaplan–Meier curves for overall survival in patients treated with pembrolizumab and chemotherapy (a) and those treated with pembrolizumab monotherapy (b)