Consecutive Uncontrolled Gastrointestinal Immune-Related Adverse Events Induced by Pembrolizumab in a Patient with Lung Adenocarcinoma: A Case Report.

IF 0.7 Q4 ONCOLOGY

Case Reports in Oncology Pub Date : 2025-05-15 eCollection Date: 2025-01-01 DOI:10.1159/000546295

Yoshikazu Toshima, Keiki Yokoo, Koki Kamata, Takayuki Nagao, Satoshi Ota, Gen Yamada, Hirofumi Chiba

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Abstract

Introduction: Immune-checkpoint inhibitors, such as pembrolizumab, have been used for non-small cell lung cancer treatment but are often associated with immune-related adverse events (irAEs).

Case presentation: A 71-year-old female was diagnosed with lung adenocarcinoma (cT3N0M1c; BRN, cStage IVB [UICC-8th edition]) and was treated with pembrolizumab monotherapy, achieving a partial response. After five cycles, she developed anorexia and abdominal pain, and upper gastrointestinal endoscopy revealed hemorrhagic gastritis because of irAEs. Systemic steroids improved the gastritis, and pembrolizumab was re-administered. However, after re-treatment, she developed interstitial lung disease, enteritis, and recurrent gastritis, all of which were irAEs. Despite high-dose steroids and infliximab addition, the irAEs remained uncontrolled, and the patient eventually died.

Conclusion: Caution is essential when re-administering immune-checkpoint inhibitors to patients with prior irAEs, although upper gastrointestinal irAEs are usually manageable.

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Pembrolizumab在肺腺癌患者中引起的连续不受控制的胃肠道免疫相关不良事件：1例报告。

免疫检查点抑制剂，如派姆单抗，已被用于非小细胞肺癌治疗，但通常与免疫相关不良事件（irAEs）相关。病例介绍：一名71岁女性被诊断为肺腺癌(cT3N0M1c；BRN， c期IVB [uicc -8版])，并接受派姆单抗单药治疗，获得部分缓解。5个周期后，患者出现厌食和腹痛，上消化道内窥镜检查显示出血性胃炎。全身性类固醇改善了胃炎，并重新给药派姆单抗。但再次治疗后，患者出现肺间质性疾病、肠炎、复发性胃炎，均为irae。尽管添加了大剂量类固醇和英夫利昔单抗，irae仍然不受控制，患者最终死亡。结论：尽管上胃肠道irae通常是可控的，但对既往irae患者再次使用免疫检查点抑制剂是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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