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Peer-reviewedCC BY 4.0Frontiers in Pharmacology

Immune-related adverse reactions across multiple systems in a non-small cell lung cancer patient induced by immune checkpoint inhibitors: a case report and literature review

  • Jing Li1,2
  • Dan Wang1,2
  • Lingli Zheng1,2
  • Chaomin Liu1,3
  • Ting Jiang2
  1. 1Clinical Medical College, Chengdu Medical College, Chengdu
  2. 2Department of Pharmacy, The First Affiliated Hospital of Chengdu Medical College, Chengdu
  3. 3Department of Oncology, The First Affiliated Hospital of Chengdu Medical College, Chengdu
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Abstract

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of non-small cell lung cancer (NSCLC), while overlapping multi-system immune-related adverse events (irAEs) are life-threatening and pose great clinical challenges.

Case Description: A 74-year-old male patient with stage IIIA lung squamous cell carcinoma developed bilateral ptosis, blurred vision, abnormal thyroid function, elevated muscle enzymes and cardiac biomarkers after two cycles of toripalimab combined with chemotherapy. He was diagnosed with ICI-induced myositis, myocarditis and thyroiditis. ICIs were discontinued immediately. Glucocorticoids, methimazole and levothyroxine were administered sequentially according to disease progression. The patient recovered well and underwent lobectomy successfully.

Conclusion: Elderly individuals complicated with pre-existing cardiovascular diseases are susceptible to severe immune-related adverse events. Early identification of overlapping multi-system irAEs, timely drug withdrawal and standardized immunosuppressive therapy are essential. Endocrine-immune-related adverse reactions exhibit dynamic evolution; for instance, thyroid toxicity may progress from a hyperthyroid phase to hypothyroidism, necessitating individualized monitoring and replacement therapy according to different stages of thyroid function.

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Cite

BibTeXRIS
BibTeX
@article{li2026immunerelated,
  title = {{Immune-related adverse reactions across multiple systems in a non-small cell lung cancer patient induced by immune checkpoint inhibitors: a case report and literature review}},
  author = {Jing Li and Dan Wang and Lingli Zheng and Chaomin Liu and Ting Jiang},
  journal = {Frontiers in Pharmacology},
  year = {2026},
  month = oct,
  doi = {10.3389/fphar.2026.1943059},
  url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1943059/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Immune-related adverse reactions across multiple systems in a non-small cell lung cancer patient induced by immune checkpoint inhibitors: a case report and literature review
AU  - Jing Li
AU  - Dan Wang
AU  - Lingli Zheng
AU  - Chaomin Liu
AU  - Ting Jiang
PY  - 2026
DA  - 2026/10/23
JO  - Frontiers in Pharmacology
DO  - 10.3389/fphar.2026.1943059
UR  - https://www.frontiersin.org/articles/10.3389/fphar.2026.1943059/full
AB  - Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of non-small cell lung cancer (NSCLC), while overlapping multi-system immune-related adverse events (irAEs) are life-threatening and pose great clinical challenges.  Case Description: A 74-year-old male patient with stage IIIA lung squamous cell carcinoma developed bilateral ptosis, blurred vision, abnormal thyroid function, elevated muscle enzymes and cardiac biomarkers after two cycles of toripalimab combined with chemotherapy. He was diagnosed with ICI-induced myositis, myocarditis and thyroiditis. ICIs were discontinued immediately. Glucocorticoids, methimazole and levothyroxine were administered sequentially according to disease progression. The patient recovered well and underwent lobectomy successfully.  Conclusion: Elderly individuals complicated with pre-existing cardiovascular diseases are susceptible to severe immune-related adverse events. Early identification of overlapping multi-system irAEs, timely drug withdrawal and standardized immunosuppressive therapy are essential. Endocrine-immune-related adverse reactions exhibit dynamic evolution; for instance, thyroid toxicity may progress from a hyperthyroid phase to hypothyroidism, necessitating individualized monitoring and replacement therapy according to different stages of thyroid function.
SN  - 1663-9812
ER  -