Fatal hepatitis after pembrolizumab in combination therapy with carboplatin and pemetrexed

Immunotherapy-induced hepatitis is a well-known and relatively common side effect of immune checkpoint inhibitors. It is usually mild to moderate and responds well to corticosteroids with a full recovery. However, in rare cases, severe liver injury may develop, leading to fulminant liver failure. In this case report, we present a case of acute fulminant liver failure with a fatal outcome despite adequate treatment in a 67-year-old male following a combination therapy of carboplatin, pemetrexed, and pembrolizumab for metastatic lung cancer.