Frontiers in Pharmacology (Jan 2021)
Case Report: Fatal Multiorgan Failure and Heterochronous Pneumonitis Following Pembrolizumab Treatment in a Patient With Large-Cell Neuroendocrine Carcinoma of Lung
- Xiaohong Xie,
- Xiaohong Xie,
- Fei Wang,
- Fei Wang,
- Yinyin Qin,
- Yinyin Qin,
- Xinqing Lin,
- Xinqing Lin,
- Zhanhong Xie,
- Zhanhong Xie,
- Ming Liu,
- Ming Liu,
- Ming Ouyang,
- Ming Ouyang,
- Bihui Luo,
- Bihui Luo,
- Yingying Gu,
- Yingying Gu,
- Shiyue Li,
- Shiyue Li,
- Dejian Gu,
- Rongrong Chen,
- Chengzhi Zhou,
- Chengzhi Zhou
Affiliations
- Xiaohong Xie
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Xiaohong Xie
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Fei Wang
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Fei Wang
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Yinyin Qin
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Yinyin Qin
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Xinqing Lin
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Xinqing Lin
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Zhanhong Xie
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Zhanhong Xie
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Ming Liu
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Ming Liu
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Ming Ouyang
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Ming Ouyang
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Bihui Luo
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Bihui Luo
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Yingying Gu
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Yingying Gu
- State Key Laboratory of Respiratory Disease, Department of Respiratory Pathology, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Shiyue Li
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Shiyue Li
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- Dejian Gu
- Geneplus‐Beijing, Beijing, China
- Rongrong Chen
- Geneplus‐Beijing, Beijing, China
- Chengzhi Zhou
- State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Chengzhi Zhou
- First Clinical College, Guangzhou Medical University, Guangzhou, China
- DOI
- https://doi.org/10.3389/fphar.2020.569466
- Journal volume & issue
-
Vol. 11
Abstract
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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