Lung squamous cell carcinoma complicated with immune checkpoint inhibitor-associated active tuberculosis: a case report and literature review.

Immune checkpoint inhibitors (ICIs) have become one of the standard therapeutic regimens for advanced lung cancer. However, the risk of infection-related complications induced by ICIs, particularly reactivation of tuberculosis, has attracted increasing clinical attention. Herein, we report a 72-year-old male patient with squamous cell carcinoma of the lung who developed reactivation of latent tuberculosis infection (LTBI) approximately 13 months after sequential PD-1 inhibitor therapy. During anti-tuberculosis treatment, the patient was further diagnosed with a second primary ascending colon adenocarcinoma. Combined with this index case and 26 previously published cases of ICI-associated tuberculosis infection identified via literature review, we explore the potential correlation between PD-1/PD-L1 inhibitor therapy and tuberculosis reactivation, as well as corresponding clinical manifestations and comprehensive management strategies. Our findings suggest that clinicians should attach great importance to tuberculosis screening and continuous monitoring throughout the entire course of ICI treatment. For complex patients concurrently complicated with second primary malignancies and infectious diseases, a multidisciplinary team (MDT) approach should be adopted to formulate individualized treatment regimens.