Related Experiment Video
Updated: May 12, 2026
Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Successful Plasma Exchange and Steroid Maintenance Therapy for Severe Pembrolizumab-Induced Polyradiculoneuritis in
Yuichi Sakamori1, Kentaro Hamada1, Ken Yamada2
1Department of Respiratory Medicine, Japan Red Cross Wakayama Medical Center, Wakayama, Japan.
Introduction:
Neurological immune-related adverse events (n-irAEs) caused by immune checkpoint inhibitors are rare but can be life-threatening.
Case Presentation:
A 43-year-old man with stage IVB squamous cell carcinoma of the lung developed progressive polyradiculoneuropathy 180 days after the first pembrolizumab administration. Initial treatments with high-dose corticosteroids and intravenous immunoglobulin were ineffective. Cerebrospinal fluid (CSF) analysis revealed albuminocytologic dissociation, and magnetic resonance imaging (MRI) revealed cervical nerve root hypertrophy. Plasma exchange (PE) was initiated along with steroid maintenance, resulting in gradual neurological recovery, as evidenced by improvements in the MRC score (from 32 to 56, on a scale from 0 to 60, with higher scores indicating greater muscle strength) and resolution of MRI abnormalities. Tumor control was sustained throughout the treatment.
Conclusion:
This case highlights the potential efficacy of combining PE and steroid maintenance therapy in managing severe, refractory n-irAEs without compromising oncologic outcomes.
