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Fatal Autoimmune Storm After A Single Cycle Of Anti-Pd-1 Therapy: A Case Of Lethal Toxicity But Pathological Complete Response In Metastatic Lung Adenocarcinoma, Jesús Fuentes-Antras, Paloma Peinado, Kissy Guevara-Hoyer, Cristina Díaz Del Arco, Silvia Sanchez-Ramon, Carlos Aguado

Hematology/Oncology and Stem Cell Therapy

As immunotherapy agents are incorporated into the routine oncological practice, the number of patients at the risk of immune-related adverse events has increased dramatically. However, the prompt identification and effective management of severe autoimmune complications remain a challenge. We report the case of a patient with metastatic lung adenocarcinoma who experienced a fatal autoimmune storm 3 weeks after the first dose of anti-programmed death receptor-1 (PD-1) agent pembrolizumab, which included thyroiditis, hepatitis, myositis, myocarditis, pneumonitis, and myasthenia gravis. Aggressive autoimmunity was supported by extensive T-cell and macrophage tissue infiltrates and autoantibody positivity. Remarkably, no residual tumor was found at autopsy. …