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Gemcitabine/pembrolizumab Deep venous thrombosis : case report

A 32-year-old woman developed a deep venous thrombosis during treatment with gemcitabine and pembrolizumab for metastatic lung adenocarcinoma [routes not stated; not all dosages stated] The woman, who was admitted to the emergency department with a complaint of dry cough at 27 weeks of gestation, was diagnosed as having stage IVa primary lung adenocarcinoma. At 28 weeks and 6 days of gestation, she received carboplatin AUC5 on day 1 and paclitaxel 80 mg/m2 on day 1, day 8 and day 15 4/4 weeks [sic]. At 30 weeks of gestation, she developed a respiratory infection [aetiology not stated] and a caesarean section was performed. She delivered a normal female neonate weighing 1070g. The Apgar scores of the neonate were 7, 8 and 9 at 1, 5 and 10 min, respectively. Due to the pulmonary progression, she received 4 cycles of cisplatin and pemetrexed, followed by maintenance therapy with pemetrexed. After 4 cycles, she was diagnosed as having metastatic lung adenocarcinoma (liver metastases). Therefore, she received pembrolizumab 2 mg/kg; however, after 3 cycles of pembrolizumab, she showed a progression in the liver metastases. In view of the hepatic function worsening, gemcitabine was added. Subsequently, she was diagnosed with a deep venous thrombosis, which was considered as a complication related to gemcitabine and pembrolizumab [durations of treatments to reaction onset and outcome not stated]. The woman received treatment with low molecular weight heparins [specific drug not stated]. However, she developed an ischaemic stroke and her general state worsened. Gemcitabine and pembrolizumab were stopped. She died about 12 months after the diagnosis of stage IVa primary lung adenocarcinoma [cause of death not stated]. The baby was healthy and had a normal development for her age. Soares A, et al. Treatment of lung cancer during pregnancy. Pulmonology 26: 314-317, No. 5, Sep-Oct 2020. Available from: URL: http://doi.org/10.1016/ j.pulmoe.2020.05.004

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Reactions 12 Sep 2020 No. 1821