Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report

Cytokine release syndrome (CRS) is a well-described immune-related adverse event following chimeric antigen receptor T-cell therapy, but has rarely been reported following anti-programmed death ligand-1 therapy. We report the case of a 55-year-old man with metastatic lung adenocarcinoma who presente...

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Main Authors: Chul Kim, Paul Sackstein, Jacob Zaemes
Format: Article
Language:English
Published: BMJ Publishing Group 2021-07-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/9/7/e002855.full
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author Chul Kim
Paul Sackstein
Jacob Zaemes
author_facet Chul Kim
Paul Sackstein
Jacob Zaemes
author_sort Chul Kim
collection DOAJ
description Cytokine release syndrome (CRS) is a well-described immune-related adverse event following chimeric antigen receptor T-cell therapy, but has rarely been reported following anti-programmed death ligand-1 therapy. We report the case of a 55-year-old man with metastatic lung adenocarcinoma who presented with fever, chills and hypotension. Initial labs were notable for highly elevated serum ferritin levels and mildly elevated triglyceride levels. He was ultimately diagnosed with pembrolizumab-induced CRS complicated by multiorgan failure. The patient was treated with steroids and tocilizumab with normalization of inflammatory markers and resolution of renal failure. This case not only highlights the importance of considering CRS in patients who have developed multiorgan failure after immune checkpoint inhibitor therapy, but also demonstrates clinical similarities between CRS and other hyperinflammatory states such as hemophagocytic lymphohistiocytosis.
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institution Kabale University
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publishDate 2021-07-01
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series Journal for ImmunoTherapy of Cancer
spelling doaj-art-5fb6b65bcb1145da8e5ec2dbe9e188652024-11-08T14:40:10ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262021-07-019710.1136/jitc-2021-002855Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case reportChul Kim0Paul Sackstein1Jacob Zaemes22 Division of Hematology and Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA1 Internal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USALombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, District of Columbia, USACytokine release syndrome (CRS) is a well-described immune-related adverse event following chimeric antigen receptor T-cell therapy, but has rarely been reported following anti-programmed death ligand-1 therapy. We report the case of a 55-year-old man with metastatic lung adenocarcinoma who presented with fever, chills and hypotension. Initial labs were notable for highly elevated serum ferritin levels and mildly elevated triglyceride levels. He was ultimately diagnosed with pembrolizumab-induced CRS complicated by multiorgan failure. The patient was treated with steroids and tocilizumab with normalization of inflammatory markers and resolution of renal failure. This case not only highlights the importance of considering CRS in patients who have developed multiorgan failure after immune checkpoint inhibitor therapy, but also demonstrates clinical similarities between CRS and other hyperinflammatory states such as hemophagocytic lymphohistiocytosis.https://jitc.bmj.com/content/9/7/e002855.full
spellingShingle Chul Kim
Paul Sackstein
Jacob Zaemes
Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report
Journal for ImmunoTherapy of Cancer
title Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report
title_full Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report
title_fullStr Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report
title_full_unstemmed Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report
title_short Pembrolizumab-induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma: a case report
title_sort pembrolizumab induced cytokine release syndrome in a patient with metastatic lung adenocarcinoma a case report
url https://jitc.bmj.com/content/9/7/e002855.full
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AT jacobzaemes pembrolizumabinducedcytokinereleasesyndromeinapatientwithmetastaticlungadenocarcinomaacasereport