Late onset of nivolumab-induced severe gastroduodenitis and cholangitis in a patient with stage IV melanoma
Late onset of nivolumab-induced severe gastroduodenitis and cholangitis in a patient with stage IV melanoma
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DOI：
10.2217/imt-2019-0077
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发表时间：
2019-08-01
期刊：
影响因子：
2.8
通讯作者：
Maubec, Eve
中科院分区：
文献类型：
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作者：
Calugareanu, Andreea;Rompteaux, Pierre;Maubec, Eve
抗程序性细胞死亡-1蛋白剂代表了一种治疗方法，其基于通过阻断免疫检查点来刺激宿主的免疫应答，免疫检查点是抑制生理性外周T细胞免疫应答并且对于维持自身耐受性至关重要的抑制途径。我们描述了一名接受nivolumab治疗的转移性黑色素瘤患者在完全缓解期发生的晚期严重胃肠炎和胆管炎。正电子发射断层扫描与计算机断层扫描显示弥漫性氟脱氧葡萄糖（FDG）摄取胃前上消化道症状。因此，正电子发射断层扫描与计算机断层扫描也可能是一个有用的工具，用于早期诊断亚临床胃毒性，最近显示结肠炎。此外，医生必须意识到并保持警惕，抗程序性细胞死亡-1蛋白相关的消化毒性，可能会出现在治疗过程中很晚。
Antiprogramed cell death-1 protein agents represent a therapeutic approach based on stimulating the host's immune response through blockade of immune checkpoints, inhibitory pathways that dampen the physiological peripheral T-cell immune response and are essential for maintaining self-tolerance. We describe the late onset of severe gastroduodenitis and cholangitis in a nivolumab-treated, metastatic melanoma patient in complete remission. Positron-emission tomography with computed tomography scans showed diffuse fluorodeoxyglucose (FDG) uptake in the stomach preceding upper digestive tract symptoms. Hence, positron-emission tomography with computed tomography might as well be a useful tool for early diagnosis of subclinical gastric toxicity as recently shown for colitis. Furthermore, physicians must be aware and remain vigilant to antiprogramed cell death-1 protein-related digestive toxicity that may appear very late during treatment.