Safe administration of anti-PD-1 immunotherapy in a patient with pre-existing primary biliary cholangitis.

Abstract:

:A 63-year-old female presented with cholestatic liver function tests in November 2016. Screening tests were negative for other causes and liver biopsy revealed primary biliary cholangitis (PBC) with autoimmune hepatitis (AIH) overlap. Ursodeoxycholic acid and azathioprine was initiated. In September 2018 she was diagnosed with Stage III BRAF wild-type melanoma. Azathioprine was ceased and adjuvant immunotherapy was not recommended due to the risk of worsening PBC/AIH. Surveillance PET revealed metastatic disease and she commenced pembrolizumab. Restaging PET after 4 cycles showed a complete metabolic response, with no hepatitis or other significant toxicity. We believe this is the first reported case of the safe administration of pembrolizumab in a patient with known PBC/AIH. Treatment duration in such high risk patients needs further investigation.

journal_name

Immunotherapy

journal_title

Immunotherapy

authors

Bhave P,Pham A,Gordon A,Moore M

doi

10.2217/imt-2019-0184

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

445-450

issue

7

eissn

1750-743X

issn

1750-7448

journal_volume

12

pub_type

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