Immune checkpoint inhibitors (ICI) improve the prognosis of patients with advanced non-small cell lung cancer. However, clinicians should be aware of potentially life-threatening immune-related adverse events (irAEs). We report a case of a 67-year-old man with lung adenocarcinoma who developed an acute ischemic stroke after the second administration of pembrolizumab. The patient benefited from thrombolysis and mechanical thrombectomy with improved neurological outcome. An anti-phospholipid syndrome (APS) was diagnosed. Simultaneously, he developed a grade IV autoimmune hepatitis. Both manifestations were considered irAEs and the ICI treatment was discontinued. Steroids were initiated resulting in irAEs resolution. Remarkably, the patient achieved a complete oncological response and persistent remission after one year follow-up despite early discontinuation of pembrolizumab. Of note, APS is rarely reported as irAE. To our knowledge, this is the first case reported in the context of lung cancer. A systematic review of the literature is provided.

免疫检查点抑制剂 (ICI) 可改善晚期非小细胞肺癌患者的预后。然而，临床医生应该意识到可能危及生命的免疫相关不良事件 (irAE)。我们报告了一例 67 岁男性肺腺癌患者，他在第二次使用 pembrolizumab 后发生急性缺血性卒中。该患者受益于溶栓和机械血栓切除术，神经功能改善。诊断为抗磷脂综合征（APS）。同时，他患上了IV级自身免疫性肝炎。两个都 表现被认为是 irAEs 并且 ICI 治疗被终止。开始使用类固醇导致 irAEs 消退。值得注意的是，尽管早期停用了派姆单抗，但患者在一年的随访后实现了完全的肿瘤学反应和持续缓解。值得注意的是，APS 很少被报告为 irAE。据我们所知，这是在肺癌背景下报告的首例病例。提供了对文献的系统评价。