Case Report: Serplulimab-induced checkpoint inhibitor pneumonitis in extensive-stage small cell lung cancer with underlying COPD: a case report and literature review.
- 1Department of Respiratory and Critical Care Medicine, Zhejiang University School of Medicine Second Affiliated Hospital Linping Campus, Hangzhou, Zhejiang, China.
Abstract
Background
Serplulimab, a first-line therapy for extensive-stage small cell lung cancer (ES-SCLC), can cause checkpoint inhibitor pneumonitis (CIP). The clinical features and outcomes of serplulimab-induced CIP in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage IV chronic obstructive pulmonary disease (COPD) remain unclear.Case description
An 80-year-old man with ES-SCLC and preexisting GOLD stage IV COPD received first-line serplulimab plus chemotherapy. After achieving an initial partial response, chemotherapy was discontinued due to reduced tolerance following bacterial pneumonia, and he was continued on serplulimab monotherapy. Three days after the first maintenance dose of serplulimab, he presented with acute severe chest tightness, dyspnea, and hypoxemia and was admitted to the hospital 4 days later. Chest CT revealed new bilateral pulmonary infiltrates. Extensive workup for infection, acute exacerbation of COPD, and tumor progression was negative; the case was ultimately classified as grade 4 serplulimab-induced CIP. He was treated with high-dose methylprednisolone, intravenous immunoglobulin, and empiric anti-infective therapy, with significant clinical improvement. Follow-up CT at 2 months post-discharge showed significant resolution of pulmonary infiltrates.Conclusions
Severe, life-threatening CIP can occur in elderly patients with ES-SCLC and preexisting GOLD stage IV COPD. In this patient, prompt recognition, intensive immunosuppression, and permanent programmed death-1 (PD-1) inhibitor discontinuation contributed to a favorable outcome. Whether preexisting GOLD stage IV COPD confers an increased risk of severe CIP in this understudied population warrants further investigation.
Related
- Clinical, Radiologic, and Highest-Grade Assessment of Immune Checkpoint Inhibitor Pneumonitis in Non–Small Cell Lung Cancer
- 1027 Foundation-model-based CT detection of pneumonitis-compatible abnormalities during immune checkpoint inhibitor surveillance
- Immune Checkpoint Inhibitor-Associated Pneumonitis in Patients Treated for Metastatic Renal Cell Carcinoma.
- Influenza A (H1N1) virus infection complicated by checkpoint inhibitor pneumonitis: A case report.
- Corticosteroid-refractory checkpoint inhibitor pneumonitis in lung cancer: biological heterogeneity and mechanism-informed management
BibTeX
@article{ju2026case,
title = {{Case Report: Serplulimab-induced checkpoint inhibitor pneumonitis in extensive-stage small cell lung cancer with underlying COPD: a case report and literature review.}},
author = {Jiangang Ju and Qiang Shen and Qingqing Chen and Linfeng Shen and Xiaofang Fu},
journal = {Frontiers in oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1935484},
url = {https://europepmc.org/article/MED/42898293},
note = {CC BY},
}
RIS
TY - JOUR
TI - Case Report: Serplulimab-induced checkpoint inhibitor pneumonitis in extensive-stage small cell lung cancer with underlying COPD: a case report and literature review.
AU - Jiangang Ju
AU - Qiang Shen
AU - Qingqing Chen
AU - Linfeng Shen
AU - Xiaofang Fu
PY - 2026
DA - 2026/10/05
JO - Frontiers in oncology
DO - 10.3389/fonc.2026.1935484
UR - https://europepmc.org/article/MED/42898293
AB - Background Serplulimab, a first-line therapy for extensive-stage small cell lung cancer (ES-SCLC), can cause checkpoint inhibitor pneumonitis (CIP). The clinical features and outcomes of serplulimab-induced CIP in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage IV chronic obstructive pulmonary disease (COPD) remain unclear.Case description An 80-year-old man with ES-SCLC and preexisting GOLD stage IV COPD received first-line serplulimab plus chemotherapy. After achieving an initial partial response, chemotherapy was discontinued due to reduced tolerance following bacterial pneumonia, and he was continued on serplulimab monotherapy. Three days after the first maintenance dose of serplulimab, he presented with acute severe chest tightness, dyspnea, and hypoxemia and was admitted to the hospital 4 days later. Chest CT revealed new bilateral pulmonary infiltrates. Extensive workup for infection, acute exacerbation of COPD, and tumor progression was negative; the case was ultimately classified as grade 4 serplulimab-induced CIP. He was treated with high-dose methylprednisolone, intravenous immunoglobulin, and empiric anti-infective therapy, with significant clinical improvement. Follow-up CT at 2 months post-discharge showed significant resolution of pulmonary infiltrates.Conclusions Severe, life-threatening CIP can occur in elderly patients with ES-SCLC and preexisting GOLD stage IV COPD. In this patient, prompt recognition, intensive immunosuppression, and permanent programmed death-1 (PD-1) inhibitor discontinuation contributed to a favorable outcome. Whether preexisting GOLD stage IV COPD confers an increased risk of severe CIP in this understudied population warrants further investigation.
SN - 2234-943X
ER -