A Case of Pulmonary Fibrosis and COVID-19-Related Pneumonia in a Pembrolizumab-Treated Patient

Pembrolizumab is used as a first-line treatment of non-small cell lung cancer. Pneumonitis and interstitial lung disease are among the most common immune-related adverse events. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with cancer treated with...

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Main Authors: Alberto Zolezzi, Gina Gualano, Annelisa Mastrobattista, Pietro Vittozzi, Virginia Di Bari, Carlotta Cerva, Silvia Mosti, Antonio Lugini, Fabrizio Albarello, Federica Di Stefano, Maria Beatrice Valli, Fabrizio Palmieri
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Infectious Disease Reports
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Online Access:https://www.mdpi.com/2036-7449/17/3/53
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Summary:Pembrolizumab is used as a first-line treatment of non-small cell lung cancer. Pneumonitis and interstitial lung disease are among the most common immune-related adverse events. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with cancer treated with chemotherapy or immune checkpoint inhibitors (ICIs) is not fully known. Blocking immune checkpoints may conversely augment dysfunctional T-cell responses in severe patients and, in turn, mediate immunopathology. Here, we present a case of SARS-CoV-2 infection complicated by acute respiratory distress syndrome (ARDS) and a fibrotic-like pattern in a patient treated with pembrolizumab for lung cancer. The patient showed a dramatic clinical and radiological response after steroid therapy. Further research is needed to better understand the long-term implications of pembrolizumab therapy in patients recovering from coronavirus disease 2019 (COVID-19) and to develop evidence-based guidelines for managing these complex cases. Patients undergoing oncologic immunotherapy might benefit from early high-dose steroid treatment in cases of viral infections, such as SARS-CoV-2.
ISSN:2036-7449