ArticleTranslational cancer research2025
Amyopathic dermatomyositis associated with immune checkpoint inhibitor therapy in lung adenocarcinoma: a case report.
Article in Translational cancer research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Immune checkpoint inhibitors (ICIs) have proven efficacious in various types of cancers, including lung cancer, but they usually lead to a set of organ-specific immune-related adverse events (irAEs). In particular, checkpoint inhibitor pneumonitis (CIP) requires special attention because it is difficult to diagnose and can be potentially fatal. Accumulating real-world epidemiological data indicate that CIP is more common than previously reported. Amyopathic dermatomyositis (ADM), which shows no or minimal muscle damage, is positive for anti-melanoma differentiation-associated gene 5 (anti-MDA5) and involves unique skin findings, as well as clinical features of rapidly progressive interstitial lung disease (RP-ILD). Therefore, knowing how to differentiate between CIP and ADM-related RP-ILD is important, which can provide valuable experience for subsequent treatment of patients. Case Description: We report a case of a patient with stage IV lung adenocarcinoma who developed ADM associated with RP-ILD following the administration of pembrolizumab, an inhibitor of the programmed cell death 1 (PD-1) pathway. The principal adverse reactions to pembrolizumab are irAEs. However, pembrolizumab-associated ADM has not been previously reported in clinical settings. The patient presented with atypical skin lesions and tested positive for anti-MDA5 antibodies, accompanied by severe acute ILD. Conclusions: We believe this case represents a valuable clinical reference for the future management of irAEs caused by pembrolizumab and emphasizes the necessity of early screening for anti-melanoma differentiation associated protein 5 (MDA5) antibodies in patients with CIP presenting as RP-ILD.
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