Encefalitis autoinmune por pembrolizumab en anciano con carcinoma no microcítico avanzado de pulmón. Caso clínico / Pembrolizumab-associated autoimmune encephalitis in an elderly patient with advanced non-small cell lung cancer. A clinical case

Los objetivos terapéuticos en el paciente geriátricoson la mejora de su calidad de vida y de su capacidadfuncional frente al mero incremento de su supervivencia. En patología neoplásica, la decisión de iniciar tratamiento curativo, especialmente inmunoterapia, deberealizarse tras una completa valoración de los riesgospotenciales. El paciente geriátrico es más susceptiblea desarrollar reacciones adversas y de mayor gravedadque el paciente más joven.Se presenta el caso de un anciano octogenario concarcinoma no microcítico pulmonar que desarrolló toxicidad neurológica tras tratamiento con pembrolizumab. Se realiza un diagnóstico diferencial de encefalitisy una revisión de los casos de encefalitis autoinmunepor pembrolizumab para mejorar nuestro conocimiento de esta infrecuente toxicidad. El trabajo interdisciplinar y la valoración geriátrica integral son elementosesenciales para prevenir el deterioro funcional del anciano.(AU)

Therapeutic objectives for the geriatric patient areimprovement of quality of life and functional capacityrather than a mere increase in survival. In neoplasticdisease, the decision to initiate administration of curative therapies, especially immunotherapy, shouldbe taken only after any potential risks have been takeninto account. Geriatric patients are more susceptibleto developing more serious adverse reactions than theyounger population.We report the case of an octogenarian patient withnon-small cell lung cancer who developed neurologictoxicity following pembrolizumab therapy. We carryout a differential diagnosis of encephalitis and providea literature review of pembrolizumab-associated au-toimmune encephalitis cases in order to improve ourknowledge of this unusual toxicity. An interdisciplinaryapproach and comprehensive geriatric assessment areessential components to prevent functional decline inthe elderly.(AU)

[Pembrolizumab-associated autoimmune encephalitis in an elderly patient with advanced non-small cell lung cancer. A clinical case].

Therapeutic objectives for the geriatric patient are improvement of quality of life and functional capacity rather than a mere increase in survival. In neoplastic disease, the decision to initiate administration of curative therapies, especially immunotherapy, should be taken only after any potential risks have been taken into account. Geriatric patients are more susceptible to developing more serious adverse reactions than the younger population. We report the case of an octogenarian patient with non-small cell lung cancer who developed neurologic toxicity following pembroli-zumab therapy. We carry out a differential diagnosis of encephalitis and provide a literature review of pembrolizumab-associated auto-immune encephalitis cases in order to improve our knowledge of this unusual toxicity. An interdisciplinary approach and comprehensive geriatric assessment are essential components to prevent functional decline in the elderly.