1. Antiphospholipid syndrome-induced ischemic stroke following pembrolizumab: Case report and systematic review
- Author
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Marie Dagonnier, Nathalie Nagy, Valérie Durieux, Vito Tota, Laure Binet, Marie Diaz, Stéphane Holbrechts, Jose-Antonio Elosegi, and Didier Wery
- Subjects
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 - Abstract
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
- Published
- 2021