Cholestatic Liver Injury Induced by Pembrolizumab in a Patient with Lung Adenocarcinoma

Intern Med. 2019;58(22):3283-3287. doi: 10.2169/internalmedicine.2591-18. Epub 2019 Nov 15.

Abstract

The anti-programmed cell death-1 protein monoclonal antibody, pembrolizumab is an immune checkpoint inhibitor. While it improves the prognoses of patients with advanced non-small-cell lung cancer, it has been reported to induce various kinds of immune-related adverse events, including hepatotoxicity. Despite the frequency of hepatotoxicity, there is only limited information available regarding the pathophysiology and treatment. We herein report a 48-year-old man with lung adenocarcinoma who was treated with pembrolizumab and developed cholestatic liver injury. In this case, the importance of evaluating the histology of hepatotoxicity and the effectiveness of ursodeoxycholic acid for cholestatic liver injury is indicated.

Keywords: cholestatic liver injury; hepatotoxicity; immune checkpoint inhibitor; ursodeoxycholic acid.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung / drug therapy*
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Cholestasis / chemically induced*
  • Cholestasis / drug therapy
  • Humans
  • Lung Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Treatment Outcome
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • Ursodeoxycholic Acid
  • pembrolizumab