A Case of Posterior Reversible Encephalopathy Syndrome Associated With Pembrolizumab and Cetuximab Combination Therapy

Neeja Patel; Rohan Karanth; Dayna J Isaacs; Joss Cohen; Deborah J Wong; Sean D Delshad

doi:10.7759/cureus.71867

A Case of Posterior Reversible Encephalopathy Syndrome Associated With Pembrolizumab and Cetuximab Combination Therapy

Cureus. 2024 Oct 19;16(10):e71867. doi: 10.7759/cureus.71867. eCollection 2024 Oct.

Authors

Neeja Patel¹, Rohan Karanth¹, Dayna J Isaacs¹, Joss Cohen², Deborah J Wong³, Sean D Delshad¹

Affiliations

¹ Internal Medicine, University of California Los Angeles Santa Monica Medical Center, Santa Monica, USA.
² Neurology, University of California Los Angeles Santa Monica Medical Center, Santa Monica, USA.
³ Hematology and Medical Oncology, University of California Los Angeles Santa Monica Medical Center, Santa Monica, USA.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a neurologic condition with a constellation of symptoms, including altered mentation, headaches, and often seizures. Immunosuppressive therapies and, more recently, immunotherapy have been identified as risk factors for PRES. We describe the first documented case of PRES associated with a combination of pembrolizumab and cetuximab therapy. This case presentation aims to highlight a rare but potential adverse effect associated with immunotherapy. Awareness of this association and early recognition of symptoms can lead to prompt management and resolution of PRES. Further research is needed to elucidate the mechanisms and risk factors contributing to PRES.

Keywords: cancer immunotherapy; cetuximab; hematology-oncology; immune-related adverse event (irae); pembrolizumab side effect; posterior reversible encephalopathy syndrome (pres).

Publication types

Case Reports