Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature

Abstract Several studies have demonstrated increased pericardial effusion during anti‐PD‐1 immunotherapy, and treatment in patients who have developed pericardial tamponade is controversial. In this study, we describe a 63‐year‐old woman with stage IVA lung adenocarcinoma given pembrolizumab as a fi...

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Main Authors: Kazuaki Harada, Makoto Ogasawara, Akane Shido, Akimitsu Meno, Soichiro Oda, Shota Yoshida, Sonoe Yoshida, Ayumu Yoshikawa, Ko Ebata, Satoshi Abiko, Naoki Kawagishi, Itsuki Sano, Hisashi Oda, Takuto Miyagishima
Format: Article
Language:English
Published: Wiley 2020-05-01
Series:Thoracic Cancer
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Online Access:https://doi.org/10.1111/1759-7714.13399
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author Kazuaki Harada
Makoto Ogasawara
Akane Shido
Akimitsu Meno
Soichiro Oda
Shota Yoshida
Sonoe Yoshida
Ayumu Yoshikawa
Ko Ebata
Satoshi Abiko
Naoki Kawagishi
Itsuki Sano
Hisashi Oda
Takuto Miyagishima
author_facet Kazuaki Harada
Makoto Ogasawara
Akane Shido
Akimitsu Meno
Soichiro Oda
Shota Yoshida
Sonoe Yoshida
Ayumu Yoshikawa
Ko Ebata
Satoshi Abiko
Naoki Kawagishi
Itsuki Sano
Hisashi Oda
Takuto Miyagishima
author_sort Kazuaki Harada
collection DOAJ
description Abstract Several studies have demonstrated increased pericardial effusion during anti‐PD‐1 immunotherapy, and treatment in patients who have developed pericardial tamponade is controversial. In this study, we describe a 63‐year‐old woman with stage IVA lung adenocarcinoma given pembrolizumab as a first‐line therapy. After four cycles of pembrolizumab treatment, the patient suddenly developed a pericardial tamponade. Although pericardial effusion was increased, her tumor lesions were reduced. After an emergency pericardiocentesis, she continued the pembrolizumab therapy without recurrent pericardial effusions for three months until the primary tumor and lymph node metastasis progressed. Nine months after the pericardiocentesis, the patient died of progressive lung cancer, but pericardial effusion did not recur throughout the treatment course. This case study suggests that pembrolizumab therapy can be continued with a strict follow‐up in some patients with pembrolizumab‐induced pericardial tamponade. Key points • Significant findings of the study Our patient developed pericardial tamponade during pembrolizumab treatment but continued pembrolizumab treatment after emergency pericardiocentesis without recurrent pericardial effusions. • What this study adds Pembrolizumab treatments may be resumed with a strict follow‐up in some patients with treatment‐related pericardial tamponade.
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spelling doaj-art-71c79c31b16a44a5aa306e598f2a22b52025-08-26T10:24:35ZengWileyThoracic Cancer1759-77061759-77142020-05-011151350135310.1111/1759-7714.13399Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literatureKazuaki Harada0Makoto Ogasawara1Akane Shido2Akimitsu Meno3Soichiro Oda4Shota Yoshida5Sonoe Yoshida6Ayumu Yoshikawa7Ko Ebata8Satoshi Abiko9Naoki Kawagishi10Itsuki Sano11Hisashi Oda12Takuto Miyagishima13Department of Medical Oncology Kushiro Rosai Hospital Kushiro JapanDepartment of Cardiovascular Medicine Kushiro Kojinkai Kinen Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanDepartment of Internal Medicine Kushiro Rosai Hospital Kushiro JapanAbstract Several studies have demonstrated increased pericardial effusion during anti‐PD‐1 immunotherapy, and treatment in patients who have developed pericardial tamponade is controversial. In this study, we describe a 63‐year‐old woman with stage IVA lung adenocarcinoma given pembrolizumab as a first‐line therapy. After four cycles of pembrolizumab treatment, the patient suddenly developed a pericardial tamponade. Although pericardial effusion was increased, her tumor lesions were reduced. After an emergency pericardiocentesis, she continued the pembrolizumab therapy without recurrent pericardial effusions for three months until the primary tumor and lymph node metastasis progressed. Nine months after the pericardiocentesis, the patient died of progressive lung cancer, but pericardial effusion did not recur throughout the treatment course. This case study suggests that pembrolizumab therapy can be continued with a strict follow‐up in some patients with pembrolizumab‐induced pericardial tamponade. Key points • Significant findings of the study Our patient developed pericardial tamponade during pembrolizumab treatment but continued pembrolizumab treatment after emergency pericardiocentesis without recurrent pericardial effusions. • What this study adds Pembrolizumab treatments may be resumed with a strict follow‐up in some patients with treatment‐related pericardial tamponade.https://doi.org/10.1111/1759-7714.13399Immune checkpoint inhibitorpembrolizumabpericardial effusionpericardial tamponade
spellingShingle Kazuaki Harada
Makoto Ogasawara
Akane Shido
Akimitsu Meno
Soichiro Oda
Shota Yoshida
Sonoe Yoshida
Ayumu Yoshikawa
Ko Ebata
Satoshi Abiko
Naoki Kawagishi
Itsuki Sano
Hisashi Oda
Takuto Miyagishima
Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature
Thoracic Cancer
Immune checkpoint inhibitor
pembrolizumab
pericardial effusion
pericardial tamponade
title Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature
title_full Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature
title_fullStr Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature
title_full_unstemmed Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature
title_short Pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma: A case report and review of the literature
title_sort pericardial tamponade during pembrolizumab treatment in a patient with advanced lung adenocarcinoma a case report and review of the literature
topic Immune checkpoint inhibitor
pembrolizumab
pericardial effusion
pericardial tamponade
url https://doi.org/10.1111/1759-7714.13399
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