Cherukuri PB, Tayyeb M, Gaddameedi SR, Du D, Meghal T. Pembrolizumab-induced Guillain-Barré syndrome in triple-negative breast cancer: A case report. World J Clin Oncol 2025; 16(2): 97823 [DOI: 10.5306/wjco.v16.i2.97823]
Corresponding Author of This Article
Phani Bhavana Cherukuri, MD, Department of Internal Medicine, Monmouth Medical Center, 300 2nd Avenue, Long Branch, NJ 07740, United States. dr.bhavana.cherukuri22@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Feb 24, 2025; 16(2): 97823 Published online Feb 24, 2025. doi: 10.5306/wjco.v16.i2.97823
Pembrolizumab-induced Guillain-Barré syndrome in triple-negative breast cancer: A case report
Phani Bhavana Cherukuri, Muhammad Tayyeb, Sai Rakshith Gaddameedi, Doantrang Du, Trishala Meghal
Phani Bhavana Cherukuri, Muhammad Tayyeb, Sai Rakshith Gaddameedi, Doantrang Du, Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, United States
Trishala Meghal, Department of Hematology Oncology, Monmouth Medical Center, Long Branch, NJ 07740, United States
Author contributions: Cherukuri PB conceptualized the paper, wrote the abstract, introduction, and case presentation sections of the paper, and created the literature review table; Gaddameedi SR contributed to the case discussion; Tayyeb M provided essential input in reviewing the manuscript for important intellectual content; Du D and Meghal T supervised and assisted with the final editing; and all authors thoroughly reviewed and endorsed the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Phani Bhavana Cherukuri, MD, Department of Internal Medicine, Monmouth Medical Center, 300 2nd Avenue, Long Branch, NJ 07740, United States. dr.bhavana.cherukuri22@gmail.com
Received: June 10, 2024 Revised: October 21, 2024 Accepted: November 8, 2024 Published online: February 24, 2025 Processing time: 184 Days and 7 Hours
Abstract
BACKGROUND
The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers, including triple-negative breast cancer. However, it is associated with immune-related adverse events, including rare but serious neurological complications such as Guillain-Barré syndrome (GBS). GBS is a potentially life-threatening autoimmune disorder characterized by muscle weakness and paralysis. We present a unique case of pembrolizumab-induced GBS to highlight the importance of recognizing this complication and managing it promptly in patients receiving immune checkpoint inhibitors.
CASE SUMMARY
A 69-year-old woman with a medical history of hypertension, anxiety, depression, and stage IIIB triple-negative breast cancer treated with pembrolizumab, carboplatin, and paclitaxel, presented to the emergency department with a 1-month history of tingling, lower extremity weakness, and shooting pain. Symptoms progressed to global weakness, ascending paralysis, and double vision. Neurological examination revealed significant lower extremity weakness and sensory deficits. Magnetic resonance imaging of the lumbar spine and cerebrospinal fluid analysis confirmed GBS. Initial treatment with intravenous immunoglobulin led to relapse, requiring additional intravenous immunoglobulin and high-dose glucocorticoids. The patient’s condition improved, pembrolizumab therapy was permanently discontinued, and she was discharged to a rehabilitation facility.
CONCLUSION
Pembrolizumab can induce GBS, necessitating early recognition, prompt diagnosis, and multidisciplinary management to prevent serious complications.
Core Tip: The immune checkpoint inhibitor pembrolizumab can cause rare immune-related adverse events like Guillain-Barré syndrome. This report details a patient with stage IIIB triple-negative breast cancer who developed Guillain-Barré syndrome after pembrolizumab treatment. Initial treatment with intravenous immunoglobulin was insufficient, but a combination of intravenous immunoglobulin and high-dose steroids led to significant improvement. This case highlights the importance of recognizing neurological complications in patients treated with pembrolizumab and emphasizes the need for timely diagnosis and multidisciplinary management of such complications.
