Pembrolizumab
From IDWiki
Background
- Monoclonal antibody to programmed cell death 1 (PD-1)
- Increases anti-tumour T-cell response by blocking interaction between PD-1 on T-cells and PD-L1 on cancer cells
- Indications include melanoma and non-small cell lung cancer
Safety
Adverse Effects
- Immune-related adverse events are common
Immune-Mediated Pneumonitis
- Pneumonitis in a life-threatening side effect occuring in 1-5% of treated patients1
- Slightly more frequent in patients with known asthma or COPD, or who have received chest radiation
- Median time to onset is 2.8 months
- Most cases are mild to moderate, though there has been at least one death
- Pattern on radiography is of ILD (mostly organizing pneumonia, but occasionally NSIP), hypersensitivity pneumonitis, or ground-glass opacities2
- May be managed with prednisone
Infections
- Not particularly immunosuppressive
- Severe infections include mainly bacterial infections (pneumonia, genitourinary infection, SSTI, and bacteremia)
- Possibly occasional viral infections (enterovirus and rhinovirus), rare fungal infections
References
- ^ Vincent Leroy, Carole Templier, Jean-Baptiste Faivre, Arnaud Scherpereel, Clement Fournier, Laurent Mortier, Lidwine Wemeau-Stervinou. Pembrolizumab-induced pneumonitis. ERJ Open Research. 2017;3(2):00081-2016. doi:10.1183/23120541.00081-2016.
- ^ Myriam Delaunay, Grégoire Prévot, Samia Collot, Laurent Guilleminault, Alain Didier, Julien Mazières. Management of pulmonary toxicity associated with immune checkpoint inhibitors. European Respiratory Review. 2019;28(154):190012. doi:10.1183/16000617.0012-2019.
