Description
Adina Martin, Andrei Tica, Dan Gheorghe Mălăescu, Marius Stancu, Liviu Martin
Immune-mediated adverse reactions in patients receiving pembrolizumab are of varying severity, going as far as exitus. Most immune-mediated adverse reactions occurring during treatment with this substance were reversible by discontinuation of immunotherapy, corticosteroid administration and/or supportive treatment. This type of side effects occurred even after the last dose of pembrolizumab. They may affect one or more appliances/system, in which case they may occur simultaneously. Appropriate assessment to confirm the etiology or exclusion of other causes is absolutely necessary if immune-mediated adverse reactions are suspected. The severity of the adverse reaction dictates the postponement of pembrolizumab and corticosteroids should be administered until symptomatology improved, at which point gradual discontinuation of corticotherapy should be initiated. If immune-mediated adverse reactions cannot be controlled with corticosteroids, the administration of other systemic immunosuppressants may be considered. Resuming pembrolizumab immunotherapy may be done within 12 weeks of the last dose administered (to maintain the therapeutic effect) if the adverse reaction improves to grade ≤ 1 and the daily dose of corticosteroid has been reduced to ≤ 10 mg prednisone or equivalent.
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