Antiphospholipid syndrome-induced ischemic stroke following pembrolizumab: Case report and systematic review
| Autor: | Marie Dagonnier, Nathalie Nagy, Valérie Durieux, Vito Tota, Laure Binet, Marie Diaz, Stéphane Holbrechts, Jose-Antonio Elosegi, Didier Wery |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Acute ischemic stroke Context (language use) Autoimmune hepatitis Pembrolizumab Antibodies Monoclonal Humanized Brain Ischemia Immune checkpoint inhibitors Non-small cell lung cancer Antiphospholipid syndrome Carcinoma Non-Small-Cell Lung Internal medicine Immune-related adverse event medicine Humans Adverse effect Lung cancer Aged Ischemic Stroke business.industry Thrombolysis Antiphospholipid Syndrome medicine.disease Cancérologie Oncology Adenocarcinoma business |
| Zdroj: | Lung cancer, 160 |
| ISSN: | 0169-5002 |
| Popis: | Immune checkpoint inhibitors (ICI) improve the prognosis of patients with advanced non-small cell lung cancer. However, clinicians should be aware of potentially life-threatening immune-related adverse events (irAEs). We report a case of a 67-year-old man with lung adenocarcinoma who developed an acute ischemic stroke after the second administration of pembrolizumab. The patient benefited from thrombolysis and mechanical thrombectomy with improved neurological outcome. An anti-phospholipid syndrome (APS) was diagnosed. Simultaneously, he developed a grade IV autoimmune hepatitis. Both manifestations were considered irAEs and the ICI treatment was discontinued. Steroids were initiated resulting in irAEs resolution. Remarkably, the patient achieved a complete oncological response and persistent remission after one year follow-up despite early discontinuation of pembrolizumab. Of note, APS is rarely reported as irAE. To our knowledge, this is the first case reported in the context of lung cancer. A systematic review of the literature is provided. SCOPUS: re.j info:eu-repo/semantics/published |
| Databáze: | OpenAIRE |
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