Anti-PD-1 Therapy-Associated Perforating Colitis

Romulo Celli1, Harriet M Kluger2, Xuchen Zhang1

  • 1Department of Pathology, Section of Medical Oncology, Yale University School of Medicine, New Haven, CT, USA.

Insights

Immune checkpoint inhibitors like PD-1 blockers can cause colitis. This case highlights a rare instance of colonic perforation associated with PD-1 inhibitor treatment for advanced melanoma.

Area of Science:

  • Oncology
  • Immunology

Background:

  • Immune checkpoint inhibitors targeting programmed cell death protein 1 (PD-1), its ligand (PDL-1), and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) are established treatments for advanced cancers.
  • While immune-related adverse effects like colitis are known for these therapies, perforating colitis linked to anti-PD-1/PD-L1 agents is uncommon.

Observation:

  • A patient with metastatic melanoma developed colonic perforation.
  • This event occurred following recent treatment with pembrolizumab, a PD-1 inhibitor.

Findings:

  • This case represents a rare occurrence of perforating colitis associated with anti-PD-1/PD-L1 therapy.
  • The patient's condition was linked to pembrolizumab treatment for metastatic melanoma.

Implications:

  • Increased awareness of anti-PD-1/PD-L1-associated colitis and perforation is crucial.
  • Timely diagnosis and management are essential for patients receiving these increasingly utilized immunotherapies.

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