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Print ISSN: 2632-2900 Online ISSN: 2632-2919
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November-December 2020 Volume 2 Issue 6

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Case Report Open Access

Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report

  • Authors:
    • Yazheng Dang
    • Mingwei Wang
    • Wei Li
    • Hongxiang Gao
    • Shigao Huang
    • Tao Qi
  • View Affiliations / Copyright

    Affiliations: Department of Radiation Oncology, 986 Hospital Affiliated to The Fourth Military Medical University, Xi'an, Shaanxi 710054, P.R. China, Department of Radiotherapy, The Third People's Hospital Affiliated to Nantong University, Nantong, Jiangsu 226000, P.R. China, Department of Radiotherapy Oncology, Chang An Hospital, Xi'an, Shaanxi 710010, P.R. China, Cancer Centre, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR 999078, P.R. China
    Copyright: © Dang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 22
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    Published online on: August 13, 2020
       https://doi.org/10.3892/wasj.2020.63
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Abstract

Anti‑PD‑1 and PD‑L1 inhibitors are associated with several adverse events, including a spectrum of immune‑related adverse effects (irAEs). Neurologic irAEs are uncommon occurrences with varied presentations. The present study presents a case of facial nerve injury irAEs associated with adjuvant pembrolizumab therapy (Keytruda®), which exhibited unusual presentations. A 44‑year‑old male patient with extensive‑stage small‑cell lung cancer (ES‑SCLC) was treated with a 6‑cycle etoposide and cisplatin (EP) regimen followed by 200 mg pembrolizumab (Keytruda®) intravenously once every 3 weeks. Magnetic resonance imaging (MRI) imaging of the brain revealed that there were abnormal enhancement areas in the left pontine crus, with clear boundaries. The patient terminated the use of pembrolizumab; however, EP chemotherapy continued and he was treated with high‑dose hormone therapy with the resolution of neurological symptoms. A total of 40 mg methylprednisolone was administered for 5 days and the patient was then administered oral prednisone tablets (25 mg). After 1 week, the facial symptoms were significantly alleviated. Following hormone therapy, the re‑examination of head MRI revealed that the lesion had shrunk and the symptoms had improved. The patient remains disease‑free. Facial nerve injury of neurological irAEs is uncommon adverse events in the context of PD‑1 inhibitor therapy. The neurotoxicity caused by immune checkpoint inhibitors (ICIs) should be a cause of concern. The early recognition of neurological irAEs is critical for the initiation of specific anti‑inflammatory agents for the prevention of such events. These events are usually alleviated with hormone therapy, which can distinguish metastatic tumors from neuropathy.
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Copy and paste a formatted citation
Spandidos Publications style
Dang Y, Wang M, Li W, Gao H, Huang S and Qi T: Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report. World Acad Sci J 2: 22, 2020.
APA
Dang, Y., Wang, M., Li, W., Gao, H., Huang, S., & Qi, T. (2020). Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report. World Academy of Sciences Journal, 2, 22. https://doi.org/10.3892/wasj.2020.63
MLA
Dang, Y., Wang, M., Li, W., Gao, H., Huang, S., Qi, T."Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report". World Academy of Sciences Journal 2.6 (2020): 22.
Chicago
Dang, Y., Wang, M., Li, W., Gao, H., Huang, S., Qi, T."Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report". World Academy of Sciences Journal 2, no. 6 (2020): 22. https://doi.org/10.3892/wasj.2020.63
Copy and paste a formatted citation
x
Spandidos Publications style
Dang Y, Wang M, Li W, Gao H, Huang S and Qi T: Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report. World Acad Sci J 2: 22, 2020.
APA
Dang, Y., Wang, M., Li, W., Gao, H., Huang, S., & Qi, T. (2020). Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report. World Academy of Sciences Journal, 2, 22. https://doi.org/10.3892/wasj.2020.63
MLA
Dang, Y., Wang, M., Li, W., Gao, H., Huang, S., Qi, T."Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report". World Academy of Sciences Journal 2.6 (2020): 22.
Chicago
Dang, Y., Wang, M., Li, W., Gao, H., Huang, S., Qi, T."Facial nerve injury immune‑related adverse events associated with adjuvant pembrolizumab therapy: A case report". World Academy of Sciences Journal 2, no. 6 (2020): 22. https://doi.org/10.3892/wasj.2020.63
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