Onkologie 2020: 14(Suppl.G): 179-183 | DOI: 10.36290/xon.2020.101

Pembrolizumab in treating lung adenocarcinoma with malignant pericardial effusion

Juraj Kultan, Ondřej Fischer

Klinika plicních nemocí a tuberkulózy, FN a LF UP Olomouc

Immunotherapy is a well-established treatment modality for metastatic-stage lung cancer which represent majority of newly diagnosed cases. The most common metastatic sites are: contralateral lung, lymph nodes, brain, adrenal glands, skeleton, and liver. Cardiac involvement is among the less frequent types of lung cancer spread, but it is associated with a worse prognosis in patients. The condition most commonly seen in the clinical practice is pericardial involvement, characterized by accumulation of fluid in the pericardial cavity - malignant pericardial effusion. In some cases it is severe even life-threatening condition associated with impending cardiac tamponade. In terms of time, it can be encountered initially, i.e. at and/or prior to diagnosis, as well as in the course of treatment or during follow-up of patients as the disease progresses. Pericardial effusion (a non-malignant one) may also develop in association with the administration of systemic treatment, including immunotherapy, as well as following radiotherapy. We report a case of a female patient in whom malignant pericardial effusion had been diagnosed and treated before the confirmation of lung cancer. Following its successful management and the subsequent micromorphological typing of predictive markers, treatment with pembrolizumab could be initiated that has continued to this day and has resulted in nearly complete disease regression.

Keywords: non-small cell lung cancer (NSCLC), malignant pericardial effusion, pembrolizumab.

Published: January 8, 2021  Show citation