PMC9875126_01
Timeline presenting the main events throughout the patient's treatment. CT, computer tomography; PD, progression of disease.
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The first 200 mg pembrolizumab dose was administered 3 weeks after diagnosis ( Figure 1 ).
Follow-up of liver enzyme levels and daily prednisolone dose in a patient with NSCLC. Blue line: (A) Alanine aminotransferase (IU/L), (B) aspartate transaminase (IU/L), (C) alkaline phosphatase (IU/L), (D) gamma-glutamyl (IU/L) transferase. Gray bars: Daily prednisolone dose (mg).  : Sample drawn for pembrolizumab quantification after pembrolizumab administration.    : Upper boundary of the liver enzymes' normal range.
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Nineteen days after administration, the patient presented with elevated levels of alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl (gamma-GT) transferase ( Figure 2 ).
Observed pembrolizumab levels after a 200 mg per 3 weeks (Q3W) administration.  : Linear pembrolizumab clearance (samples from 19, 40, 42, 49, 53, 60, 70, 74, and 77 days after administration).  : Non-linear pembrolizumab clearance (samples from 82, 88, 89, and 90 days after administration).  : Below the lower limit of detection (samples from 91 and 123 days after administration).
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The highest pembrolizumab level of 9.1 microg/mL, as seen in  Figure 3 , was observed in the earliest sample collected (19 days after the 200 mg pembrolizumab administration).