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Published on: September 25, 2018
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[Pembrolizumab-induced gastritis with PDL1 histological expression]
Carla Nicolini1, Natalia Manzano1, Santiago Flagel1
1Instituto Alexander Fleming, Buenos Aires, Argentina.
Medicina
|December 20, 2023
Summary
Immune checkpoint inhibitors like pembrolizumab can cause rare immune-mediated gastritis. This case highlights diagnosis and treatment of this adverse effect in cervical cancer patients.
Area of Science:
- Oncology
- Immunology
- Gastroenterology
Background:
- Immune checkpoint inhibitors (ICIs) harness the immune system to fight cancer.
- Immune-mediated adverse effects (irAEs) are known complications of ICI therapy.
- Gastritis is a rare irAE associated with ICIs.
Observation:
- A cervical carcinoma patient on pembrolizumab presented with nausea, vomiting, and weight loss.
- Endoscopy revealed ulcerated lesions in the gastric antrum and body.
- Biopsy showed significant gastric mucosal damage and inflammatory infiltrate.
Findings:
- Immunohistochemistry confirmed PD-L1 expression (CPS 35%) on tumor cells and inflammatory cells.
- The patient responded to corticosteroid treatment (meprednisone).
- Follow-up endoscopy showed improved gastric mucosa with residual superficial ulcers.
Implications:
- This case underscores the importance of recognizing immune-mediated gastritis in patients receiving ICIs.
- Prompt diagnosis and management with corticosteroids can lead to favorable outcomes.
- Understanding ICI-induced gastritis is crucial for managing cancer patients on these therapies.
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