Multiple drugs: Cholangitis, myositis and lack of efficacy.

A 59-year-old man with lung adenocarcinoma and multiple brain metastases developed cholangitis and myositis while being treated with pembrolizumab. He also experienced lack of efficacy with azathioprine, cisplatin, and pemetrexed. The patient initially presented with visual field loss and received pembrolizumab, cisplatin, and pemetrexed. He later developed pain in his thigh and lumbar region, which was diagnosed as pembrolizumab-related myositis. Treatment with prednisolone improved his symptoms, but he subsequently developed epigastric pain and was diagnosed with pembrolizumab-related cholangitis. Despite treatment modifications, his condition did not improve, and he eventually died due to lung cancer progression. Autopsy findings confirmed the presence of myositis and sclerosing cholangitis. [Extracted from the article]