Development of Bronchopleural Fistula Following Durvalumab Consolidation for Stage III Non-Small-Cell Lung Cancer

Abstract Bronchial fistula is a serious anatomic defect in which there is an aberrant connection between the bronchus and another organ or space. These fistulas are most commonly described following tissue insults such as surgery or trauma. Recently, bronchomediastinal fistula has been reported in association with an anti-PD-L1 immunotherapy, durvalumab, for non-small cell lung cancer (NSCLC). To our knowledge however, bronchopleural fistula (BPF) has never been previously described in association with immunotherapy. In this article, we report on the development of a BPF in a patient with bulky stage III NSCLC. The patient underwent chemoradiotherapy followed by durvalumab consolidation for one year. BPF developed while a complete tumor response was observed. Endobronchial repair of BPF was attempted using fibrin glue and endobronchial valve with limited success. The patient ultimately succumbed to recurrent infections. Based on our limited experience, BPF may represent another possible bronchial complication during durvalumab consolidation in the NSCLC setting.