• Julie Malet, Boutheina Melki, Stéphane Chouabe, and Gaëtan Deslée.
• Department of Respiratory Diseases, Reims University Hospital, Reims, France.
• Medicine (Baltimore). 2022 Jul 22; 101 (29): e29612e29612.

RationaleDespite clinical-proven benefits of immune checkpoint inhibitors (ICIs) on advanced lung cancer, rare but life-threatening immune-related adverse events (irAEs) have been reported. Pancreatitis is a rare irAE that can occur with any ICI.Patient ConcernsA 53-year-old man with locally advanced non-small cell lung carcinoma was treated with radiochemotherapy and then durvalumab (anti-programmed cell death ligand 1 therapy). Twelve weeks after the beginning of ICI, he reported abdominal pain and anorexia. Blood test showed high level of lipase. Abdominal computed tomography revealed a swollen pancreas. These findings were confirmed by magnetic resonance cholangiopancreatography and biliopancreatic endoscopic ultrasonography.DiagnosesGrade IV immune-related pancreatitis.InterventionsThe patient was treated with corticosteroid therapy, resulting in clinical, radiological, and biological improvement.OutcomesDuring the first month, corticosteroid therapy could not be decreased under 1 mg/kg/d because of symptoms recurrence and lipasemia rerising. Four months after this episode, the patient died from acute ischemia of the lower limbs while he was on <20 mg/d of corticosteroid.LessonsTo the best of our knowledge, immune-related pancreatitis has been reported only with anti-programmed cell death 1 or anti-cytotoxic T lymphocyte antigen 4 therapies but never with anti-programmed cell death ligand 1 therapy. It is important to report such rare cases to improve diagnosis and management of irAEs.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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