AI Article Synopsis
- Immune checkpoint inhibitors (ICIs) can lead to rare but severe immune-related adverse events (irAEs) like pancreatitis, which was experienced by a patient undergoing treatment for advanced lung cancer.
- A 53-year-old male patient treated with durvalumab developed grade IV immune-related pancreatitis, characterized by abdominal pain and elevated lipase levels, confirmed through imaging studies.
- Although treated with corticosteroids, the patient's condition was challenging to manage, and he ultimately succumbed to unrelated complications months later, highlighting the need for awareness and further study of such rare irAEs associated with different ICI therapies.
Article Abstract
Rationale: Despite clinical-proven benefits of immune checkpoint inhibitors (ICIs) on advanced lung cancer, rare but life-threatening immune-related adverse events (irAEs) have been reported. Pancreatitis is a rare irAE that can occur with any ICI.
Patient Concerns: A 53-year-old man with locally advanced non-small cell lung carcinoma was treated with radiochemotherapy and then durvalumab (anti-programmed cell death ligand 1 therapy). Twelve weeks after the beginning of ICI, he reported abdominal pain and anorexia. Blood test showed high level of lipase. Abdominal computed tomography revealed a swollen pancreas. These findings were confirmed by magnetic resonance cholangiopancreatography and biliopancreatic endoscopic ultrasonography.
Diagnoses: Grade IV immune-related pancreatitis.
Interventions: The patient was treated with corticosteroid therapy, resulting in clinical, radiological, and biological improvement.
Outcomes: During the first month, corticosteroid therapy could not be decreased under 1 mg/kg/d because of symptoms recurrence and lipasemia rerising. Four months after this episode, the patient died from acute ischemia of the lower limbs while he was on <20 mg/d of corticosteroid.
Lessons: To the best of our knowledge, immune-related pancreatitis has been reported only with anti-programmed cell death 1 or anti-cytotoxic T lymphocyte antigen 4 therapies but never with anti-programmed cell death ligand 1 therapy. It is important to report such rare cases to improve diagnosis and management of irAEs.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302344 | PMC |
| http://dx.doi.org/10.1097/MD.0000000000029612 | DOI Listing |
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