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Acute liver failure caused by pembrolizumab in a patient with pulmonary metastatic liver cancer: A case report.

Abstract Keytruda (pembrolizumab) is an inhibitor of programmed cell death receptor-1 (PD-1), which was approved to treat advanced melanoma and nonsmall cell lung cancer patients who do not respond to other treatment. However, its efficacy and security in the treatment of advanced liver cancer is still under investigation.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390572
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - Acute liver failure caused by pembrolizumab in a patient with pulmonary
      metastatic liver cancer: A case report.
PG  - e9431
LID - 10.1097/MD.0000000000009431 [doi]
AB  - RATIONALE: Keytruda (pembrolizumab) is an inhibitor of programmed cell death
      receptor-1 (PD-1), which was approved to treat advanced melanoma and nonsmall
      cell lung cancer patients who do not respond to other treatment. However, its
      efficacy and security in the treatment of advanced liver cancer is still under
      investigation. PATIENT CONCERNS: A 60-year-old man was diagnosed with pulmonary
      metastatic liver cancer who accepted pembrolizumab treatment after the failure of
      sorafenib. When injected pembrolizumab, in spite of pulmonary metastatic lesion
      shrink, the patient experienced severe liver dysfunction. DIAGNOSES: Based on the
      features of the clinical signs and laboratory examination,the patient was
      diagnosed with pembrolizumab-induced immune-related hepatitis by excluding other 
      etiologies and drug-induced side effects. INTERVENTIONS: The patient received
      glucocorticoid and artificial liver (plasma exchange) therapy after failed
      conservative liver protection treatment. OUTCOMES: The patient's liver
      dysfunction continuously progressed and he finally died of liver failure and its 
      complications during his hospitalization. LESSONS: Pembrolizumab showed efficacy 
      in an advanced hepatocellular carcinoma patient with lung metastases. However, it
      can generate immune-related adverse events such as immune-related hepatitis which
      can be lethal.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Wu, Zhenping
AU  - Wu Z
AD  - Department of Infectious Diseases, the First Affiliated Hospital of Nanchang
      University, Nanchang, Jiangxi, China.
FAU - Lai, Lingling
AU  - Lai L
FAU - Li, Ming
AU  - Li M
FAU - Zhang, Lunli
AU  - Zhang L
FAU - Zhang, Wenfeng
AU  - Zhang W
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - DPT0O3T46P (pembrolizumab)
SB  - AIM
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/*adverse effects/therapeutic use
MH  - Antineoplastic Agents, Immunological/*adverse effects/therapeutic use
MH  - Carcinoma, Hepatocellular/*drug therapy/pathology
MH  - Humans
MH  - Liver Failure, Acute/*chemically induced
MH  - Liver Neoplasms/*drug therapy/secondary
MH  - Lung Neoplasms/*drug therapy/pathology
MH  - Male
MH  - Middle Aged
PMC - PMC5758274
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009431 [doi]
AID - 00005792-201712220-00159 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e9431. doi: 10.1097/MD.0000000000009431.