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Severe Immune Checkpoint Inhibitor-associated Gastritis Treated with Steroids and Infliximab
Koki Tanaka1, Toshiyuki Morisawa1, Norio Katayama1
1Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|September 18, 2025
Summary
A 77-year-old man developed severe immune-related gastritis from pembrolizumab for lung cancer. Steroid-refractory gastritis improved significantly with the addition of infliximab, showing its value in managing this side effect.
Area of Science:
- Oncology
- Immunology
- Gastroenterology
Background:
- Immune checkpoint inhibitors like pembrolizumab are increasingly used for lung cancer.
- Immune-related adverse events (irAEs), including gastritis, can occur with these therapies.
- Gastritis can be severe and may not respond to initial treatments.
Purpose of the Study:
- To report a case of severe immune-related gastritis.
- To highlight the challenges in managing steroid-refractory cases.
- To emphasize the role of infliximab in refractory immune-related gastritis.
Main Methods:
- A case report of a 77-year-old male lung cancer patient treated with pembrolizumab.
- Clinical presentation, endoscopic findings, and histological examination of gastritis.
- Assessment of response to initial steroid therapy and subsequent addition of infliximab.
Main Results:
- The patient developed severe immune-related gastritis unresponsive to steroids (steroid-refractory).
- Combination therapy with steroids and infliximab led to significant clinical and endoscopic improvement.
- Early endoscopic and histological diagnosis was crucial.
Conclusions:
- Immune-related gastritis is a potential severe side effect of pembrolizumab.
- Early diagnosis and prompt evaluation of treatment response are essential.
- Infliximab is an effective salvage therapy for steroid-refractory immune-related gastritis.
Keywords:
gastritisimmune checkpoint inhibitorimmune-related adverse eventinfliximabpembrolizumabsteroid-refractoryMore Related Videos
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