Life-threatening multiorgan immune-related toxicities complicated by sepsis after anti-PD-1 therapy with complete tumor regression: a case report and literature review - Summary - MDSpire
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Life-threatening multiorgan immune-related toxicities complicated by sepsis after anti-PD-1 therapy with complete tumor regression: a case report and literature review
To present a case of severe multisystem immune-related adverse events (irAEs) following anti-PD-1 treatment and to review the existing literature on concurrent-onset irAEs.
Approach:
Case Presentation: A 73-year-old man with sinonasal squamous cell carcinoma developed severe multisystem immune toxicity after pembrolizumab and nab-paclitaxel treatment, requiring intensive care and multidisciplinary management.
Management Strategy: The management included corticosteroids, intravenous immunoglobulin (IVIG), and intensive care support, focusing on balancing immune control with infection risk.
Key Findings:
The patient experienced Stevens–Johnson syndrome, hematologic and renal failure, pneumonitis, and recurrent sepsis requiring intensive care.
The patient achieved complete tumor regression after one treatment cycle.
Interpretation:
The case highlights the extreme spectrum of immunologic dysregulation associated with PD-1 blockade and the importance of rapid diagnosis and multidisciplinary management.
Limitations:
Concurrent-onset irAEs involving multiple organs are reported in less than 1% of cases, making this scenario rare.
Conclusion:
This case highlights the need for further investigation into the management of life-threatening multiorgan irAEs.
by Jun Dong, Lijun Zhang, Lei Yu, Jun Wang, Jijie Huang, Xiaoyan Wu, Ping-An Wu, Suling Chen, Xixi Chen, Wenjuan Zhu, Yuan Qu, Jishi Li, Victor Ho Fun Lee
