Would you continue pembrolizumab in an asymptomatic metastatic NSCLC patient with high PD-L1, who develops granulomatous mediastinal lymphadenopathy biopsy proven as sarcoid?   

Sarcoid-like granulomatous reactions have been described with checkpoint inhibitors. It is important to diagnose them when they occur, in order to not confuse these findings with disease progression, especially in a patient with lung cancer. I have had two patients at least show growing mediastinal ...