Exacerbation of cancer-associated retinopathy with anti-recoverin antibodies during atezolizumab treatment for extensive-stage small cell lung cancer: A case report.

Tomoaki Nakamura, Tatsuya Yoshida, Kohdai Kitamoto, Ken Masuda, Yi-Ning Chen, Yasushi Goto

Journal: Respiratory investigation 2025;63(5):1033-1036

PMID: 40796404

Full Text on Elsevier Science View on PubMed

Abstract

Atezolizumab in combination with chemotherapy is a standard treatment for extensive-stage small cell lung cancer (SCLC). However, it can induce immune-related adverse events and exacerbate autoimmune conditions. Cancer-associated retinopathy (CAR) is a known paraneoplastic syndrome in SCLC, but its interaction with immune checkpoint inhibitor (ICI) therapy remains poorly understood. Here, we present a case of visual impairment following two cycles of chemotherapy plus atezolizumab. Notably, the patient had elevated and had high anti-recoverin antibody titers prior to treatment initiation, ICI therapy may have exacerbated pre-existing subclinical CAR.

Address: Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. Electronic address: [email protected].; Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Department of Experimental Therapeutics, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. Electronic address: [email protected].; Department of Ophthalmology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.; Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.; Department of Ophthalmic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

DOI: 10.1016/j.resinv.2025.08.001

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MeSH Terms: Humans, Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols, Autoantibodies, Immune Checkpoint Inhibitors, Lung Neoplasms, Neoplasm Staging, Paraneoplastic Syndromes, Ocular, Recoverin, Small Cell Lung Carcinoma