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Delayed immune-mediated hepatitis after three cycles of pembrolizumab for the treatment of sinonasal melanoma


1 Division of Hematology and Oncology, Department of Internal Medicine, Chungnam National University Hospital and College of Medicine, Daejeon, Republic of Korea
2 Department of Pathology, Chungnam National University Hospital and College of Medicine, Daejeon, Republic of Korea

Correspondence Address:
HJ Lee,
Division of Hematology and Oncology, Department of Internal Medicine, Chungnam National University Hospital and College of Medicine, Daejeon
Republic of Korea
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpgm.jpgm_834_22

PMID: 37376755

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that induce the anti-tumor effects of T cells by targeting co-inhibitory immune checkpoints. The development of ICIs has revolutionized the clinical practice of oncology, leading to significant improvements in outcomes; therefore, ICIs are now standard care for various types of solid cancers. Immune-related adverse events, the unique toxicity profiles of ICIs, usually develop 4–12 weeks after initiation of ICI treatment; however, some cases can occur >3 months after cessation of ICI treatment. To date, there have been limited reports about delayed immune-mediated hepatitis (IMH) and histopathologic findings. Herein, we present a case of delayed IMH that occurred 3 months after the last dose of pembrolizumab, including histopathologic findings of the liver. This case suggests that ongoing surveillance for immune-related adverse events is required, even after cessation of ICI treatment.


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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow