Table.
Clinical Features of Anti-PD-1 Antibody-induced Pancreatitis.
| Case | Age Sex | Type of cancer | Anti-PD-1 antibody | Period from ICI introduction to onset | Clinical symptoms | Elevation in pancreatic enzyme | Imaging features of the pancreas | Treatment | Outcome | |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 (8) | 65 M | Melanoma | P | 3 months | Anorexia, weight loss | Positive | CT | Localized enlargement (body-tail) |
Prednisolone | Improved |
| 2 (9) | 74 F | RCC | N | 4 months | Abdominal pain | Positive | CT | Diffuse enlargement | Prednisolone | Died |
| 3 (10) | 57 M | Melanoma | P | 3 cycles | No symptoms | N/A | PET | Diffuse FDG uptake | N/A | N/A |
| 4 (11) | 66 F | NSCLC | N | 18 days | Vomiting, back pain | Positive | CT MRI PET |
No abnormalities No abnormalities No FDG uptakes |
Prednisolone | Improved |
| 5 (12) | 70 M | NSCLC | P | 14 months | No symptoms | Positive | CT PET |
Diffuse enlargement Localized FDG uptake |
Prednisolone | Improved |
| 6 (13) | 72 M | NSCLC | N | N/A | No symptoms | Positive | CT PET |
Diffuse enlargement Diffuse FDG uptake |
Cessation of ICI | Improved |
| 7 (14) | 70 F | RCC | N | 6 months | N/A | Positive | MRI EUS ERCP |
Diffuse enlargement Hypoechoic enlargement Skipped narrowing of the MPD |
Cessation of ICI | Improved |
| 8 (15) | 43 M | Melanoma | P | 8 months | Abdominal fullness | Negative | CT | Diffuse enlargement | PD | Improved |
| 9 (16) | 65 M | NSCLC | P | 2 months | Abdominal tenderness | Positive | CT | Diffuse enlargement | Limit oral intake | Improved |
| 10 (17) | 62 M | Cancer of unknown primary | P | 9 months | Epigastric pain | Positive | CT | Diffuse enlargement fluid collection around the pancreas | Prednisolone | Died |
| This case | 69 M | NSCLC | P | 16 months | No symptoms | Negative | CT MRI EUS ERCP |
Localized enlargement Stricture of the lower CBD Localized enlargement Skipped narrowing of the MPD |
Limit oral intake, intravenous hydration | Improved |
M: male, F: female, NSCLC: non-small cell lung cancer, RCC: renal cell carcinoma, PD-1: programmed cell death 1, ICI: immune checkpoint inhibitor, P: pembrolizumab, N: nivolumab, N/A: not available, CT: computed tomography, PET: positron emission tomography, MRI: magnetic resonance imaging, EUS: endoscopic ultrasonography, ERCP: endoscopic retrograde cholangiopancreatography, CBD: common bile duct, MPD: main pancreatic duct, FDG: 18F-fluorodeoxyglucose, PD: pancreaticoduodenectomy