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Updated: Aug 29, 2025
Monitoring PD-1-Blocking Antibodies Bound to T Cells Derived from a Drop of Peripheral Blood
Published on: February 5, 2020
Fatal toxicity induced by anti-PD-1 immune checkpoint inhibitor in thymic epithelial tumor
Xuquan Jing1,2, Hui Zhu1,2, Yuying Li1,2
1Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Shandong University Cancer Center, Shandong University, Jinan, Shandong, 250117, China.
Abstract:
A standard treatment for advanced thymic epithelial tumors (TETs) after initial treatment remains unavailable to date. Targeted immune checkpoint inhibitors (ICIs) of the programmed cell death-1 (PD-1) pathway may produce objective responses in TETs, notably thymic carcinoma. Findings of clinical trials suggested ICIs are a practical choice. However, the risk of severe immuno-related adverse events is higher in TETs. Concerning histologic subtypes, thymomas are more frequently associated with autoimmune disorders than carcinomas, so close monitoring is needed for thymomas. In this article, we describe four cases of fatal toxicity caused by anti-PD-1 therapy in TETs. Four patients with metastatic thymomas or carcinoma difficult to treat with first-line standard chemotherapy were treated with the anti-PD-1 drug pembrolizumab or sintilimab. The association of PD-1 inhibitors with a high proportion of severe immuno-related adverse events in TETs necessitates attentive monitoring during treatment.
Insights
Immune checkpoint inhibitors targeting programmed cell death-1 (PD-1) show promise for advanced thymic epithelial tumors (TETs). However, severe toxicities, including fatal events, necessitate careful patient monitoring during treatment.
Area of Science:
- Oncology
- Immunotherapy
Background:
- Standard treatment for advanced thymic epithelial tumors (TETs) is lacking.
- Immune checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1) pathway offer potential therapeutic options for TETs, particularly thymic carcinoma.
Purpose of the Study:
- To describe cases of fatal toxicity associated with anti-PD-1 therapy in patients with advanced thymic epithelial tumors.
- To highlight the risks and need for monitoring of severe immune-related adverse events in TETs treated with PD-1 inhibitors.
Main Methods:
- Retrospective analysis of four patients with metastatic thymomas or thymic carcinoma.
- Treatment with anti-PD-1 agents (pembrolizumab or sintilimab) after failure of first-line chemotherapy.
Main Results:
- Four patients experienced fatal toxicities attributed to anti-PD-1 therapy.
- A high proportion of severe immune-related adverse events were observed in this TET patient cohort.
Conclusions:
- Anti-PD-1 therapy is associated with a significant risk of severe toxicity in thymic epithelial tumors.
- Close monitoring for immune-related adverse events is crucial for patients with TETs undergoing treatment with PD-1 inhibitors.
