ReviewFrontiers in immunology2026
Life-threatening multiorgan immune-related toxicities complicated by sepsis after anti-PD-1 therapy with complete tumor regression: a case report and literature review.
Review in Frontiers in immunology, 2026. 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Immune checkpoint inhibitors (ICIs) enhance antitumor immunity but can disrupt immune tolerance, leading to immune-related adverse events (irAEs) affecting multiple organs. Simultaneous life-threatening multiorgan irAEs remain rare and poorly characterized, particularly in head and neck cancer. Case presentation: A 73-year-old man with sinonasal squamous cell carcinoma developed fulminant multisystem immune toxicity after a single dose of pembrolizumab combined with nab-paclitaxel. The clinical course was marked by Stevens-Johnson syndrome, hematologic and renal failure, pneumonitis, metabolic dysregulation, and recurrent sepsis requiring intensive care. A multidisciplinary strategy, including team discussion, intensive care, corticosteroids and two courses of intravenous immunoglobulin (IVIG), was employed. Dose-escalated corticosteroids may cause potent immunosuppression and potentially raise the risk of opportunistic infections. IVIG serves as an immunomodulator which can balance immune control with infection risk. His organ function recovered despite concurrent catheter-related systemic infection. Remarkably, the patient achieved complete tumor regression after one treatment cycle and disease-free duration was 6 months. Conclusion: This case illustrates the extreme spectrum of immunologic dysregulation associated with PD-1 blockade and highlights the importance of rapid and early diagnosis, multidisciplinary management, and risk-adapted immunomodulation. IVIG may represent a pragmatic therapeutic strategy when escalation of immunosuppression is limited by infection risk. Further investigation is needed to optimize prediction and management of life-threatening multiorgan irAEs.
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