Vascular Thrombosis and Anti-PD-1 Therapy: A Series of Cases

Abstract

Immune checkpoint inhibitors may cause unique immune-related adverse events. Vascular thrombosis, especially arterial thrombosis, is rare but life-threatening, and little is known about its relevance to immunotherapy. Here, we reported two cases of vascular thrombosis, including venous and arterial thrombosis in cancer patients receiving anti-PD-1 antibody in combination with chemotherapy. Systemic corticosteroids and anticoagulant treatment were administered immediately in two cases. In case 1, anti-PD-1 antibody was permanently discontinued, and recurrence of vascular thrombosis was not observed during the follow-up. In case 2, the patient continued anti-PD-1 immunotherapy and unfortunately died of cerebral infarction 2 months later. This case report provides a strong evidence for the association between PD-1 blockade and vascular thrombosis and offers some general guidelines on the management of the immune-related vascular thrombosis events induced by anti-PD-1 therapy.

Keywords:

• immune checkpoint inhibitors
• immune-related adverse events
• pembrolizumab
• tislelizumab
• pulmonary embolism
• deep vein thrombosis

Ethics Approval

The study was approved by the ethics committee of the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China.

Consent for Publication

Written informed consents were obtained from the patients for publication of two cases report and any accompanying images.

Disclosure

The authors report no conflicts of interest in this work.