An autopsy case of lung adenocarcinoma with immune checkpoint inhibitor-induced pneumonia and fulminant myocarditis following pembrolizumab administration: a case report.

Pembrolizumab 给药后 ， 肺腺癌合并免疫检查点抑制剂引起的肺炎和暴发性心肌炎的尸检病例 ： 病例报告。

• 发表时间: 2024 Jul
• 来源期刊: Int Cancer Conf J
• DOI: 10.1007/s13691-024-00665-7
• PMID: 38962041
• 文章类型: Journal Article
• 作者列表: Hashimoto T,Takahashi K,Ito K,Iwade K,Torii A,Sugihara M,Kondo H,Hara T

关键词: Immune checkpoint inhibitors; Immune-related adverse events; Interstitial pneumonia; Myocarditis; Non-small-cell carcinoma

Abstract

Immune checkpoint inhibitors (ICIs) are the current standard of care for non-small-cell lung cancer (NSCLC). Myocarditis is a rare but serious immune-related adverse event (irAE) associated with ICI therapy. We present a patient who received a single dose of pembrolizumab for NSCLC and developed ICI-associated pneumonia. Although pneumonia improved with corticosteroid therapy, the patient subsequently developed ICI-associated fulminant myocarditis. Despite high-dose corticosteroid therapy, the patient died on day 30 after pembrolizumab initiation. Even if an observed irAE was effectively treated, clinicians should remain vigilant for other irAEs, especially those that are difficult to control with low-dose corticosteroids.

摘要

免疫检查点抑制剂(ICIs)是非小细胞肺癌(NSCLC)的当前护理标准。心肌炎是与ICI治疗相关的罕见但严重的免疫相关不良事件（irAE）。我们介绍了一名接受单剂量派姆单抗治疗NSCLC并发展为ICI相关性肺炎的患者。尽管使用皮质类固醇治疗可改善肺炎，患者随后发展为ICI相关的暴发性心肌炎.尽管接受了高剂量的皮质类固醇治疗,患者在pembrolizumab开始治疗后第30天死亡.即使观察到的irAE得到了有效治疗，临床医生应该对其他不良反应保持警惕，尤其是那些难以用低剂量皮质类固醇控制的患者。