A case of acute myocarditis induced by PD-1 inhibitor (sintilimab) in the treatment of large cell neuroendocrine carcinoma

Siming Zheng; Haiyu Zhang; Bingshuang Hu; Jiaxiong Zhou; Lei Wen; Minying Li

doi:10.1016/j.heliyon.2023.e16874

A case of acute myocarditis induced by PD-1 inhibitor (sintilimab) in the treatment of large cell neuroendocrine carcinoma

Heliyon. 2023 Jun 3;9(6):e16874. doi: 10.1016/j.heliyon.2023.e16874. eCollection 2023 Jun.

Authors

Siming Zheng¹, Haiyu Zhang¹, Bingshuang Hu¹, Jiaxiong Zhou¹, Lei Wen¹, Minying Li¹

Affiliation

¹ Second Department of Radiotherapy, Zhongshan People's Hospital (Zhongshan Hospital of Sun Yat-Sen University), Zhongshan, Guangdong 528400, China.

Abstract

The combination of Sintilimab with pemetrexed/platinum has become the first-line treatment for non-squamous non-small-cell lung carcinoma (NSCLC). Here, we report a patient with metastatic large cell neuroendocrine carcinoma (LCNEC) treated with Sintilimab for five cycles who developed shortness of breath after activity. The level of creatine kinase (CK), creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT) were significantly increased. The cardiac MR suggested that heart function was slightly decreased. Considering that the patient did not take any illicit drugs, without history of autoimmune disease, coronary heart disease, arrhythmia, or chronic heart failure, we diagnosed the patient with Sintilimab-induced myocarditis. The symptoms alleviated after rapid use of glucocorticoids. Myocarditis is a rare immune-related adverse events (irAEs), especially myocarditis induced by programmed cell death receptor-1 (PD-1) inhibitor in the treatment of LCNEC.

Keywords: Immune checkpoint inhibitors (ICIs); Immune-related adverse events (irAEs); Myocarditis large cell neuroendocrine carcinoma (LCNEC); Sintilimab.

Publication types

Case Reports