A Case of Acute Exacerbation of Hepatitis B by Pembrolizumab for a Lung Adenocarcinoma Patient with Hepatitis B Surface Antigen

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  • ペムブロリズマブ投与によりB型肝炎急性増悪をきたしたHBs抗原陽性肺腺癌の1例

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<p>Background. The induction of immune-related adverse events (irAEs) by immune checkpoint inhibitors (ICIs) has been widely reported. However, measures for controlling hepatitis B in patients receiving ICIs have not been established. Case. A 54-year-old woman with lung adenocarcinoma was not screened for blood hepatitis B virus (HBV) prior to or during initial chemotherapy. Acute hepatic injury appeared after the administration of pembrolizumab for cancer relapse. The patient was positive for HBsAg, and the liver function fortunately recovered following the administration of nucleoside analogue. It was presumed that specific T cell induced by programmed death ligand-1 (PD-L1) antibody attached HBV-infected liver cells, subsequently causing liver injury. After the liver injury improved, pembrolizumab therapy was restarted and continued for more than two years without relapse. Conclusion. ICIs can cause acute exacerbation of hepatitis B. This instructive case report suggests the importance of blood HBV screening, even for the single use of the drug.</p>

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  • Haigan

    Haigan 60 (2), 115-119, 2020-04-20

    The Japan Lung Cancer Society

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