Pembrolizumab-induced acute thrombosis: A case report

    loading  Checking for direct PDF access through Ovid



Acute thrombosis has not been reported in the literature so far in lung cancer patients as an immune-related adverse event (irAE) associated with PD-1 pathway inhibitors.

Patients concerns:

Here, we for the first time present two NSCLC (non-small cell lung cancer) patients suffering from acute thrombosis as a pembrolizumab-induced irAE. Immediate treatment with continuous heparin infusion improved their symptoms and enabled them to continue pembrolizumab administration.


Ethical approval was given by the ethics committee of Osaka International Cancer Institute and the informed consents were given by the patients.


Serum D-dimer level testing, venous ultrasonography, enhanced computed tomography (CT).


Continuous heparin infusion, direct oral anticoagulants (DOAC).


Immediate continuous heparin infusion improved their symptoms and continuing pembrolizumab with direct oral anticoagulant successfully induced tumor shrinkage.


Reinvigoration of exhausted T cells by pembrolizumab induced systemic inflammation possibly resulting in development of thrombosis. Although acute thrombosis is a rare irAE, it may lead to cessation of treatment and can be lethal.

Related Topics

    loading  Loading Related Articles