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Tislelizumab-induced anaphylactic shock: a case report
Haiyu Niu1, Feixue Song1, Xiaochun Zhou2
1Department of Oncology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, 730030, China.
Discover Oncology
|July 10, 2025
Summary
Tislelizumab, an anti-PD-1 therapy for small-cell lung cancer, can cause rare but severe anaphylactic shock during initial infusions. Prompt recognition and management are crucial for patient safety.
Area of Science:
- Oncology
- Immunotherapy
- Pharmacovigilance
Background:
- Immune-checkpoint inhibitors (ICIs) revolutionized cancer treatment but can cause immune-related adverse events (irAEs).
- Tislelizumab, an anti-PD-1 antibody, generally has a favorable safety profile with rare reports of severe hypersensitivity.
- Small-cell lung cancer (SCLC) treatment often involves ICIs, necessitating vigilance for adverse reactions.
Purpose of the Study:
- To report a rare case of anaphylactic shock during first-line tislelizumab therapy for metastatic SCLC.
- To highlight the potential for life-threatening hypersensitivity reactions to tislelizumab, even upon initial exposure.
- To emphasize the importance of monitoring and preparedness for managing severe adverse events during ICI treatment.
Main Methods:
- A case report of a 61-year-old male patient diagnosed with extensive-stage SCLC.
- Initiation of first-line treatment with tislelizumab plus carboplatin-etoposide.
- Immediate cessation of infusion and administration of emergency interventions upon onset of anaphylactic symptoms.
Main Results:
- The patient experienced acute anaphylactic shock, including dyspnoea and loss of consciousness, within minutes of starting tislelizumab infusion.
- Vital signs stabilized following immediate medical intervention, including cardiopulmonary resuscitation and administration of dexamethasone, diphenhydramine, and epinephrine.
- Anaphylaxis secondary to tislelizumab was diagnosed, with no prior history of allergy or contraindications identified.
Conclusions:
- Tislelizumab can induce severe, life-threatening hypersensitivity reactions, including anaphylaxis, even during the first infusion.
- Oncologists must maintain a high index of suspicion for hypersensitivity, closely monitor patients during initial infusions, and be prepared for immediate resuscitation.
- Further pharmacovigilance is essential to determine the true incidence and risk factors for tislelizumab-related anaphylaxis.
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