Pembrolizumab

Abstract

Acquired immune-related pneumonitis : case report A 55-year-old man developed acquired immune-related pneumonitis following treatment with pembrolizumab for multiple primary lung cancer (MPLC). The heavy smoker man hospitalised in April 2019 due to chest pain. His further investigation showed MPLC. Thus, he started receiving chemotherapy cycles with pemetrexed with pembrolizumab [route and dosage not stated] 25 May 2019. After three cycles of the chemotherapy, he developed pyrexia, dyspnoea, fatigue and dry cough on 19 July 2019. His CT scan showed multiple newonset diffused patchy shadows and ground-glass opacities distributed in his both lungs. Laboratory test showed increase in erythrocyte sedimentation rate and C-reactive protein level. Thus, he received unspecified antibiotic therapy. However, no response was noted and he was diagnosed with grade 3 acquired immune-related pneumonitis [duration of treatment to reaction onset not stated]. Hence, pembrolizumab was stopped and the man was treated with prednisone that led to alleviation in symptoms. Eventually, prednisone was tapered off and he underwent wedge resection of the left upper lung. Twelve months after discontinuation of immunotherapy, he had almost complete remission of ground-glass opacity, associated with the tailing effect of pembrolizumab.