An unusual case of checkpoint-inhibitor-induced pleuropericarditis

J Oncol Pharm Pract. 2023 Sep;29(6):1525-1528. doi: 10.1177/10781552231179369. Epub 2023 May 30.

Abstract

Introduction: Pembrolizumab is an immune checkpoint inhibitor that promotes effector T-cell functions on malignant cells by binding to programmed cell death protein 1 (PD-1). Pembrolizumab is well tolerated in most cases with an adverse event profile consisting mainly of pruritus, fatigue, and anorexia. Cardiotoxicity comprises 1% of the total adverse events.

Case report: We present a case of a 64-year-old female with non-small cell lung cancer (NSCLC) who developed pleuropericarditis following pembrolizumab therapy.

Management & outcome: The patient was successfully managed with colchicine, furosemide, and timely initiation of methylprednisolone with the improvement of her symptoms. The decision to discontinue pembrolizumab was made, and six months after this intervention, the patient has remained asymptomatic.

Discussion: Clinicians should recognize these potential immune-mediated adverse effects to provide effective and timely management and optimize patient care.

Keywords: Immune-related adverse events; NSCLC; pembrolizumab; pericarditis; pleuritis.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / therapy
  • Cardiotoxicity
  • Drug-Related Side Effects and Adverse Reactions* / drug therapy
  • Female
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Lung Neoplasms* / diagnosis
  • Middle Aged

Substances

  • Immune Checkpoint Inhibitors