Sarcoid-like reactions in patients treated with checkpoint inhibitors for advanced solid tumors Journal Article


Authors: Nykaza, I.; Murciano-Goroff, Y. R.; Desilets, A.; Harada, G.; Postow, M. A.; Callahan, M. K.; Lee, C. H.; Rudin, C. M.; Kelsen, D. P.; Stadler, Z. K.; Wibmer, A. G.; Hechtman, J. F.; Drilon, A.; Friedman, C. F.
Article Title: Sarcoid-like reactions in patients treated with checkpoint inhibitors for advanced solid tumors
Abstract: Importance: While new intrathoracic adenopathy in a patient with cancer can represent progression of disease, the differential diagnosis is broad. Sarcoid-like reactions (SLR) remain an underreported source of lymphadenopathy in patients treated with immune checkpoint inhibitors (ICI), with limited reports in patients with cancers other than melanoma. Objective: To characterize SLRs among patients treated with ICI for advanced solid tumors. Methods: Data were collected on the clinical, pathologic, and radiographic presentation of patients treated with ICI who developed clinical or imaging findings suggestive of an SLR, including the presence of hilar or mediastinal lymphadenopathy, cutaneous/subcutaneous involvement, and/or worsening of existing sarcoidosis on ICI. Results: Twelve patients were identified as having experienced an SLR. While 6 patients had melanoma, SLRs were also observed among patients with lung, gynecologic, and genitourinary cancers, including high-grade serous ovarian carcinoma, and an angiomyolipoma. Median time from initiation of ICI to diagnosis of an SLR was 3.4 months (range: 1.8-9.1). All but one patient (92%) were deemed to have had a radiographic response to ICI. Conclusions and relevance: Clinicians should maintain the awareness of the possibility of SLRs in patients receiving ICI, particularly in patients whose scans show evidence of “mixed” response, with decreases in certain lesions coupled with new/increasing intrathoracic lymphadenopathy and/or other systemic signs of sarcoid. © The Author(s) 2025. Published by Oxford University Press.
Journal Title: The Oncologist
Volume: 30
Issue: 5
ISSN: 1083-7159
Publisher: Oxford University Press  
Date Published: 2025-05-01
Start Page: oyaf017
Language: English
DOI: 10.1093/oncolo/oyaf017
PUBMED: 40349135
PROVIDER: scopus
PMCID: PMC12065934
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Claire Friedman -- Source: Scopus
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MSK Authors
  1. Michael Andrew Postow
    362 Postow
  2. Zsofia Kinga Stadler
    391 Stadler
  3. Margaret Kathleen Callahan
    197 Callahan
  4. David P Kelsen
    537 Kelsen
  5. Alexander Edward Drilon
    633 Drilon
  6. Andreas Georg Wibmer
    53 Wibmer
  7. Charles Rudin
    489 Rudin
  8. Jaclyn Frances Hechtman
    212 Hechtman
  9. Chung-Han   Lee
    157 Lee
  10. Claire Frances Friedman
    117 Friedman
  11. Guilherme Harada
    28 Harada
  12. Ian Russell Nykaza
    1 Nykaza