Case Report: Hepatic sarcoidosis-like reaction from neoadjuvant pembrolizumab in early-stage triple-negative breast cancer

Front Immunol. 2025 Jun 18:16:1589191. doi: 10.3389/fimmu.2025.1589191. eCollection 2025.

Abstract

Drug-induced sarcoidosis-like reaction (DISR) is a rare adverse event associated with immunotherapy. Currently, there is no standardized treatment protocol for DISR linked to immune checkpoint inhibitors (ICIs). This study presents a case of an early-stage triple-negative breast cancer (TNBC) patient who developed hepatic sarcoidosis-like reactions during neoadjuvant pembrolizumab therapy. We provide an overview of ICI-induced sarcoidosis-like reactions in cancer patients, including incidence, mechanisms, clinical manifestations, treatment, and prognosis. Additionally, we discuss the significance of one-year adjuvant immunotherapy for early-stage TNBC patients who achieved pathological complete response after neoadjuvant therapy, offering insights for individualized therapeutic strategies in this population.

Keywords: early breast cancer; neoadjuvant immunotherapy; pembrolizumab; sarcoidosis-like reaction; triple-negative breast cancer.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Antineoplastic Agents, Immunological* / adverse effects
  • Chemical and Drug Induced Liver Injury* / diagnosis
  • Chemical and Drug Induced Liver Injury* / etiology
  • Female
  • Humans
  • Immune Checkpoint Inhibitors* / adverse effects
  • Middle Aged
  • Neoadjuvant Therapy / adverse effects
  • Neoplasm Staging
  • Sarcoidosis* / chemically induced
  • Sarcoidosis* / diagnosis
  • Triple Negative Breast Neoplasms* / drug therapy
  • Triple Negative Breast Neoplasms* / pathology

Substances

  • pembrolizumab
  • Antibodies, Monoclonal, Humanized
  • Immune Checkpoint Inhibitors
  • Antineoplastic Agents, Immunological