Pembrolizumab and the pancreas: Case report of a rare immune reaction

Pancreatitis is defined as inflammation of the pancreas, a large heterocrine (both endocrine and exocrine) gland situated beneath the stomach. Pembrolizumab is an immune checkpoint inhibitor that acts by inhibiting programmed cell death protein 1 to treat various cancers. Pancreatitis is a rare adverse event of pembrolizumab. We report the case of a 59-year-old male patient with non-metastatic renal cell carcinoma post-nephrectomy who developed subclinical pancreatitis while on adjuvant pembrolizumab. He was managed with close monitoring in accordance with current National Comprehensive Cancer Network guidelines. This case highlights the importance of maintaining a high level of clinical suspicion for the early recognition by healthcare practitioners as well as appropriate causality assessment and pharmacovigilance in managing these rare immune checkpoint-associated adverse events.