Table 3.
irAEs.
Grade 1 | Grade 2 | Grade 3 | Grade 4 | |
---|---|---|---|---|
Neoadjuvant (n = 31) | ||||
Diarrhea/colitis | 6 (19.4%) | 0 | 1 (3.2%) | 0 |
Rash | 3 (9.7%) | 2 (6.5%) | 0 | 0 |
AST/ALT increased | 1 (3.2%) | 0 | 0 | 0 |
Endocrinopathya | 1 (3.2%) | 0 | 1 (3.2%) | 0 |
Hemolysis | 0 | 0 | 1 (3.2%) | 0 |
Myocarditisb | 0 | 0 | 0 | 1 (3.2%) |
CNS palsy | 0 | 1 (3.2%) | 0 | 0 |
Adjuvant (n = 21) | ||||
Diarrhea/colitis | 10 (47.6%) | 1 (4.8%) | 0 | 0 |
Rash | 3 (14.3%) | 1 (4.8%) | 0 | 0 |
AST/ALT increased | 1 (4.8%) | 1 (4.8%) | 3 (14.3%) | 0 |
Endocrinopathyc | 1 (4.8%) | 0 | 0 | 0 |
Palpitations | 0 | 1 (4.8%) | 0 | 0 |
Cholecystitis | 0 | 0 | 1 (4.8%) | 0 |
Hypophysitis.
The patient who developed grade 4 myocarditis presented with a complete heart block and sustained ventricular tachycardia after receiving two doses of neoadjuvant pembrolizumab. His symptoms persisted despite high-dose steroid, amiodarone and flecainide drip treatment, and dual chamber pacer, which finally and immediately resolved after plasma exchange. His left ventricular ejection fraction was maintained at about 50% throughout.
Hyperglycemia.