Pembrolizumab is a humanized monoclonal antibody targeting the PD-1 receptor expressed on the surface of cytotoxic T lymphocytes. Along with other specific antibodies, it belongs to the class of immune checkpoint inhibitors (ICI). Its use as monotherapy is particularly indicated in the first-line treatment of metastatic non-small-cell lung cancers (NSCLC) without oncogenic addition (ALK or EGFR mutations) and expressing the PD-L1 receptor at ≥50% on the surface of tumor cells, corresponding to a high tumor proportion score (TPS score), which has shown predictive of a better response to treatment (1) (2) (3). We have presented herein the case of a patient with a pembrolizumab-treated NSCLC complicated by acute interstitial nephritis (AIN) under pembrolizumab immunotherapy. Permanent discontinuation of pembrolizumab and treatment with intravenous corticosteroids enables us to gradually normalize the patient's renal function.
Nephritis is one of the rare potential undesirable effects associated with immunotherapy.
New toxicity profiles associated with immune checkpoint inhibitors require the reporting of any symptoms or biological abnormalities dedected during their use in order to initiate prompt management of these immunotherapy-related undesirable effects.
Key Words
Immunotherapy, acute interstitial nephritis, pembrolizumab, undesirable effects
What is already known about the topic?
- Pembrolizumab is a humanized monoclonal antibody targeting the PD-1 receptor expressed on the surface of cytotoxic T lymphocytes. Along with other specific antibodies, it belongs to the class of immune checkpoint inhibitors (ICI).
- Nephritis is one of the rare potential undesirable effects reported in association with immunotherapy.
- New toxicity profiles associated with immune checkpoint inhibitors require the reporting of any symptoms or biological abnormalities detected during their use in order to initiate prompt management of these immunotherapy-related undesirable effects.
What does this article bring up for us?
This article has been written in order to help educate health professionals about immune-induced nephritis and, more generally, the undesirable effects related to immunotherapy, which is increasingly used in the fight against cancer.