Tumor-related cytokine release syndrome in a treatment-naïve patient with lung adenocarcinoma: A case report

Table 1 Timeline

Time	Syndrome or treatment	Oncologic response
October 2017	Fever (maximum 41 °C), palpitation, nausea and cough for 1 mo
October 2017	Diagnosed as medium differentiated adenocarcinoma lung cancer with EGFR and ALK gene mutations negative by CT-guided puncture biopsy
November 2017	Considered have primary CRS with related to lung cancer, and treated with DXM, gamma globulin and other supporting treatments. The patient stopped fever soon
December 2017 to February 2018	Four cycles of chemotherapy with pemetrexed + cisplatin	PR
June 11, 2018	Recurrent fever for 10 d with CT showed tumor progressed again	PD
July 2018 to August 2018	Radiotherapy then stated to take	PR
August 2018	Anlotinib	PR
May 2019	Nivolumab for 5 cycles	PR
April 2019	Died	PD

EGFR: Epidermal growth factor receptor; ALK: Anaplastic lymphoma kinase; CT: Computed tomography; CRS: Cytokine release syndrome; DXM: Dexamethasone; PR: Partial remission; PD: Progressive disease.