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Vol.59 No.5 contents | Japanese/English |
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- Case Report -
The Evaluation of Four Cases of Non-small Cell Lung Cancer Requiring Pericardial Drainage After Pembrolizumab Therapy
Yusuke Sakai1, Makoto Nakao1, Sosuke Arakawa1, Yuto Suzuki1, Kohei Fujita1, Hideki Muramatsu11Department of Respiratory Medicine, Kainan Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Japan
Background. There have been a few reported cases of cardiac tamponade with several response patterns to pembrolizumab, such as pseudo-progression and a mixed response. Case. We evaluated 4 patients (67-79 years old) with stage IV non-small cell lung cancer. Three cases were adenocarcinoma, and one was squamous cell carcinoma. In two of the four cases, pericardial effusion accumulated while the reduction in the primary lung lesion was maintained. Another of the four cases showed a mixed response, with pericardial effusion increasing while the primary lesion shrank. The remaining patient experienced increasing pericardial effusion with increasing primary lesion volume. As the primary lesion size in this case was reduced at follow-up after pericardial drainage and there was no re-accumulation of pericardial fluid, we considered it to be one of pseudo-progression. In addition, in three of the four cases, pericardial effusion was observed before treatment with pembrolizumab. Conclusion. We encountered four lung cancer patients who developed pericardial effusion after pembrolizumab therapy. These cases have rarely been reported.
key words: Pembrolizumab, Immune checkpoint inhibitor, Pericardial effusion, Mixed response, Pseudo-progression
Received: April 14, 2019
Accepted: July 22, 2019
JJLC 59 (5): 482-486, 2019
