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Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung

Immune checkpoint inhibitors have radically changed the landscape of antitumor therapies in several malignancies. Despite the long-term efficacy, severe immune-related adverse events (irAEs) were not uncommon. However, fatal simultaneous multiorgan failure was rare. Here, we described a patient who...

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Autores principales: Xie, Xiaohong, Wang, Fei, Qin, Yinyin, Lin, Xinqing, Xie, Zhanhong, Liu, Ming, Ouyang, Ming, Luo, Bihui, Gu, Yingying, Li, Shiyue, Gu, Dejian, Chen, Rongrong, Zhou, Chengzhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878548/
https://www.ncbi.nlm.nih.gov/pubmed/33584255
http://dx.doi.org/10.3389/fphar.2020.569466
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author Xie, Xiaohong
Wang, Fei
Qin, Yinyin
Lin, Xinqing
Xie, Zhanhong
Liu, Ming
Ouyang, Ming
Luo, Bihui
Gu, Yingying
Li, Shiyue
Gu, Dejian
Chen, Rongrong
Zhou, Chengzhi
author_facet Xie, Xiaohong
Wang, Fei
Qin, Yinyin
Lin, Xinqing
Xie, Zhanhong
Liu, Ming
Ouyang, Ming
Luo, Bihui
Gu, Yingying
Li, Shiyue
Gu, Dejian
Chen, Rongrong
Zhou, Chengzhi
author_sort Xie, Xiaohong
collection PubMed
description Immune checkpoint inhibitors have radically changed the landscape of antitumor therapies in several malignancies. Despite the long-term efficacy, severe immune-related adverse events (irAEs) were not uncommon. However, fatal simultaneous multiorgan failure was rare. Here, we described a patient who developed multiorgan failure, including fulminant myocarditis, myasthenia gravis crisis, hepatic dysfunction, and delayed pneumonitis after pembrolizumab therapy for lung large-cell neuroendocrine carcinoma. After failure of high-dose steroid treatment, implantation of cardiac pacemaker combined with high-dose steroids successfully controlled myocarditis caused by immune checkpoint inhibitors (ICIs). Delayed pneumonitis occurred unexpectedly, and it was treated successfully with steroids. With wild adoption of ICIs in clinical practice, investigations for predictive markers of irAEs are warranted, and more successful treatment strategies are worth sharing.
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spelling pubmed-78785482021-02-13 Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung Xie, Xiaohong Wang, Fei Qin, Yinyin Lin, Xinqing Xie, Zhanhong Liu, Ming Ouyang, Ming Luo, Bihui Gu, Yingying Li, Shiyue Gu, Dejian Chen, Rongrong Zhou, Chengzhi Front Pharmacol Pharmacology Immune checkpoint inhibitors have radically changed the landscape of antitumor therapies in several malignancies. Despite the long-term efficacy, severe immune-related adverse events (irAEs) were not uncommon. However, fatal simultaneous multiorgan failure was rare. Here, we described a patient who developed multiorgan failure, including fulminant myocarditis, myasthenia gravis crisis, hepatic dysfunction, and delayed pneumonitis after pembrolizumab therapy for lung large-cell neuroendocrine carcinoma. After failure of high-dose steroid treatment, implantation of cardiac pacemaker combined with high-dose steroids successfully controlled myocarditis caused by immune checkpoint inhibitors (ICIs). Delayed pneumonitis occurred unexpectedly, and it was treated successfully with steroids. With wild adoption of ICIs in clinical practice, investigations for predictive markers of irAEs are warranted, and more successful treatment strategies are worth sharing. Frontiers Media S.A. 2021-01-29 /pmc/articles/PMC7878548/ /pubmed/33584255 http://dx.doi.org/10.3389/fphar.2020.569466 Text en Copyright © 2021 Xie, Wang, Qin, Lin, Xie, Liu, Ouyang, Luo, Gu, Li, Gu, Chen and Zhou. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Xie, Xiaohong
Wang, Fei
Qin, Yinyin
Lin, Xinqing
Xie, Zhanhong
Liu, Ming
Ouyang, Ming
Luo, Bihui
Gu, Yingying
Li, Shiyue
Gu, Dejian
Chen, Rongrong
Zhou, Chengzhi
Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung
title Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung
title_full Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung
title_fullStr Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung
title_full_unstemmed Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung
title_short Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung
title_sort case report: fatal multiorgan failure and heterochronous pneumonitis following pembrolizumab treatment in a patient with large-cell neuroendocrine carcinoma of lung
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878548/
https://www.ncbi.nlm.nih.gov/pubmed/33584255
http://dx.doi.org/10.3389/fphar.2020.569466
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