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Pericardial effusion with pembrolizumab

Laura Fernández Madrigal1, Olalla Montero Pérez2, Maria Yeray Rodriguez Garcés1

  • 1Unidad de Gestión Clínica Oncología Médica, 16839Hospital Juan Ramón Jiménez, Huelva, Spain.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|February 8, 2022
PubMed
Abstract

Insights

Pembrolizumab, a programmed cell death-1/ligand-1 (PD1/PDL-1) inhibitor, can cause immune-related adverse events (IrAEs). This case highlights pericardial effusion as a rare but serious cardiovascular IrAE, managed with corticosteroids.

Area of Science:

  • Oncology
  • Immunotherapy
  • Cardiology

Background:

  • Non-small cell lung cancer (NSCLC) treatment has evolved with immunotherapies like Pembrolizumab targeting PD1/PDL-1.
  • While generally well-tolerated, Pembrolizumab can cause serious immune-related adverse events (IrAEs) affecting various organs.

Observation:

  • A patient with stage IV NSCLC and high PD-L1 expression received Pembrolizumab combined with chemotherapy.
  • The patient presented with pericardial effusion, suspected to be a Pembrolizumab-induced IrAE.

Findings:

  • Pericardial effusion, a rare cardiovascular IrAE, was diagnosed and treated with corticosteroids.
  • The patient recovered, but immunotherapy was discontinued due to the event's severity.

Implications:

  • Cardiovascular IrAEs from PD1/PDL-1 inhibitors are infrequent but can be severe.
  • Management involves corticosteroids, with potential need for additional immunosuppressants.
  • Restarting immunotherapy requires careful consideration of AE severity, alternative treatments, and cancer response.
Keywords:
Pembrolizumabimmunotherapypericardial effusionprogrammed cell death 1programmed cell death ligand 1

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