Rapidly progressive pneumonitis days after receiving tisotumab vedotin: a new antibody–drug conjugate

The emergence of antibody-drug conjugates (ADCs) shows promise for treating a variety of tumours by using target-specific monoclonal antibodies to deliver cytotoxic substances directly to cancer cells. Their clinical development, however, is often hindered by significant toxicities. We report a case of a woman in her late 50s who developed grade 4 pneumonitis after receiving tisotumab vedotin (TV) for recurrent, metastatic squamous cell carcinoma of the cervix. 5 days post infusion, the patient exhibited severe respiratory distress, marked by hypoxaemia and diffuse ground-glass opacities on imaging. After careful ruling out of infection and alveolar haemorrhage via bronchoscopy, a presumptive diagnosis of drug-induced pneumonitis was established given the temporal relationship to receiving TV. The patient was treated with high-dose intravenous steroids and immunoglobulin, leading to eventual recovery. This case exhibits the potential for severe pulmonary toxicity associated with TV and highlights the need for greater awareness and investigation of adverse effects related to ADCs.