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

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Citation: Journal for Immunotherapy of Cancer. 9(7), 2021 07.PMID: 34330765Department: Internal Medicine Residency | MedStar Georgetown University HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Adenocarcinoma of Lung/dt [Drug Therapy] | *Antibodies, Monoclonal, Humanized/ae [Adverse Effects] | *Antineoplastic Agents, Immunological/tu [Therapeutic Use] | *Cytokine Release Syndrome/ci [Chemically Induced] | Adenocarcinoma of Lung/sc [Secondary] | Antibodies, Monoclonal, Humanized/pd [Pharmacology] | Antineoplastic Agents, Immunological/pd [Pharmacology] | Humans | Male | Middle Aged | Neoplasm MetastasisYear: 2021ISSN:
  • 2051-1426
Name of journal: Journal for immunotherapy of cancerAbstract: 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. Copyright (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.All authors: Kim C, Sackstein P, Zaemes JOriginally published: Journal for Immunotherapy of Cancer. 9(7), 2021 Jul.Fiscal year: FY2022Fiscal year of original publication: FY2022Digital Object Identifier: Date added to catalog: 2021-11-01
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Journal Article MedStar Authors Catalog Article 34330765 Available 34330765

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. Copyright (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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