Successful Treatment with Rituximab of Sjögren’s Syndrome-Associated Organizing Pneumonia in a Patient Treated with PD-L1 Blockade for Ovarian Cancer

As the use of immune checkpoint inhibitors in cancer therapy increases across a wide range of tumor types, rarer toxicities including rheumatologic immune adverse events are reported with increasing frequency. We describe the case of an ovarian cancer patient treated with durvalumab, who developed an organizing pneumonia, proved to be related to a preexisting but previously unknown asymptomatic Sjögren’s syndrome, confirmed by a positive antibody (anti-SSA and anti-SSB) panel. While resistant to corticosteroids, was ultimately successfully treated with the B-cell depleting antibody rituximab with no impact on the anticancer therapy efficacy. This case shows that patients with preexisting autoimmune diseases should not be systematically excluded from potentially life-saving anti-tumor therapies without a thorough assessment of the potential benefit in terms of efficacy and safety of the therapy.