Neuropsychiatric Immune-related Adverse Events Induced by Pembrolizumab in a Patient with Lung Adenocarcinoma and Systemic Lupus Erythematosus

Abstract

The patient was a 73-year-old woman with lung adenocarcinoma and systemic lupus erythematosus (SLE) who was treated with pembrolizumab. After six cycles of pembrolizumab, she developed symptoms suggestive of neuropsychiatric SLE, such as resting tremor, confusional state, depression, mood disorder, and anxiety disorder. In addition, her cerebrospinal fluid level of interleukin-6 was elevated. Her symptoms resolved one month after the discontinuation of pembrolizumab. This is the first report of neuropsychiatric symptoms in a patient with lung cancer and SLE on immune checkpoint blockade therapy.The patient was a 73-year-old woman who had been diagnosed with T4N2M1b adenocarcinoma of the lung in July 2017 (Fig. 1). At 68 years of age, she was diagnosed with SLE based on arthritis, pleuritis, and elevated levels of antinuclear and anti-dsDNA antibodies. She was being treated with prednisolone (5 mg/day) and tacrolimus (1 mg/day) at the time of the lung cancer diagnosis. Her tumor showed a high PDL-1 expression level (Tumor Proportion Score >50%). She began

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Autoimmune Movement Disorders Complicating Treatment with Immune Checkpoint Inhibitors

“…Of 5682 eligible papers, 26 articles 8–33 reporting 28 patients were included. A detailed PRISMA flowchart, the assessment of the risk of bias for each study, and the estimation of frequency in larger cohorts of patients with neurological irAEs are provided in Supporting Information.…”

Progressive multifocal leukoencephalopathy in systemic lupus erythematosus managed with pembrolizumab: A case report with literature review

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