{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T11:46:56Z","timestamp":1777290416096,"version":"3.51.4"},"reference-count":10,"publisher":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","issue":"2","license":[{"start":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T00:00:00Z","timestamp":1493078400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy.<\/jats:p>\n                  <jats:p>Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home.<\/jats:p>\n                  <jats:p>Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.<\/jats:p>","DOI":"10.1515\/jccm-2017-0013","type":"journal-article","created":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T06:02:06Z","timestamp":1495173726000},"page":"84-88","source":"Crossref","is-referenced-by-count":1,"title":["Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis"],"prefix":"10.62838","volume":"3","author":[{"given":"Thomas-Michael","family":"Schneider","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Krankenhaus Barmherzige Brueder , Munich, Romanstr. 93, 80639 Muenchen , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friederike","family":"Klenner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V, University of Munich , Munich , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz","family":"Brettner","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Krankenhaus Barmherzige Brueder , Munich , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"49540","published-online":{"date-parts":[[2017,5,11]]},"reference":[{"key":"2021040703220706551_j_jccm-2017-0013_ref_001_w2aab2b8b5b1b7b1ab1ab1Aa","unstructured":"1. Kobold S DP, Schnurr M, Subklewe M, RothenfusserS, Endres S. Immunotherapy in tumor-activated T-cells as a new treatment modality. Dtsch Arztebl Int. 2015;112:809-15."},{"key":"2021040703220706551_j_jccm-2017-0013_ref_002_w2aab2b8b5b1b7b1ab1ab2Aa","unstructured":"2. Makdisi G, Wang IW. Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis. 2015;7:E166-76."},{"key":"2021040703220706551_j_jccm-2017-0013_ref_003_w2aab2b8b5b1b7b1ab1ab3Aa","doi-asserted-by":"crossref","unstructured":"3. Hodi FS, O\u2019Day SJ, McDermott DF, et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med. 2010;363:711-23.","DOI":"10.1056\/NEJMoa1003466"},{"key":"2021040703220706551_j_jccm-2017-0013_ref_004_w2aab2b8b5b1b7b1ab1ab4Aa","doi-asserted-by":"crossref","unstructured":"4. Robert C, Long GV, Brady B, et al. Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med. 2015;372:320-30.","DOI":"10.1056\/NEJMoa1412082"},{"key":"2021040703220706551_j_jccm-2017-0013_ref_005_w2aab2b8b5b1b7b1ab1ab5Aa","doi-asserted-by":"crossref","unstructured":"5. Postow MA, Chesney J, Pavlick AC, et al. Nivolumab and ipilimumab versus ipilimumab in untreated melanoma. N Engl J Med. 2015;372:2006-17.","DOI":"10.1056\/NEJMoa1414428"},{"key":"2021040703220706551_j_jccm-2017-0013_ref_006_w2aab2b8b5b1b7b1ab1ab6Aa","unstructured":"6. Squibb B-M. Opdivo (Nivolumab), Immune-Mediated Adverse Reactions Management Guide. (packet insert) 2015."},{"key":"2021040703220706551_j_jccm-2017-0013_ref_007_w2aab2b8b5b1b7b1ab1ab7Aa","unstructured":"7. Villadolid J, Amin A. Immune checkpoint inhibitors in clinical practice: update on management of immune-related toxicities. Transl Lung Cancer Res. 2015;4:560-75."},{"key":"2021040703220706551_j_jccm-2017-0013_ref_008_w2aab2b8b5b1b7b1ab1ab8Aa","doi-asserted-by":"crossref","unstructured":"8. Nishino M, Sholl LM, Hodi FS, Hatabu H, Ramaiya NH. Anti-PD-1-Related Pneumonitis during Cancer Immunotherapy. N Engl J Med. 2015;373:288-90.","DOI":"10.1056\/NEJMc1505197"},{"key":"2021040703220706551_j_jccm-2017-0013_ref_009_w2aab2b8b5b1b7b1ab1ab9Aa","doi-asserted-by":"crossref","unstructured":"9. Amato MB, Barbas CS, Medeiros DM, et al. Effect of a protectiveventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998;338:347-54.","DOI":"10.1056\/NEJM199802053380602"},{"key":"2021040703220706551_j_jccm-2017-0013_ref_010_w2aab2b8b5b1b7b1ab1ac10Aa","doi-asserted-by":"crossref","unstructured":"10. Wohlfarth P, Ullrich R, Staudinger T, et al. Extracorporeal membrane oxygenation in adult patients with hematologic malignancies and severe acute respiratory failure. 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