Immune checkpoint inhibitor associated reactivation of primary membranous nephropathy responsive to rituximab.
Immune checkpoint inhibitor associated reactivation of primary membranous nephropathy responsive to rituximab.
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DOI：
10.1136/jitc-2020-001287
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发表时间：
2020-10
影响因子：
10.9
通讯作者：
Abudayyeh A
中科院分区：
文献类型：
--
作者：
Lin JS;Wang DY;Mamlouk O;Glass WF;Abdelrahim M;Yee C;Abudayyeh A
介导来自检查点抑制剂（CPI）的抗肿瘤免疫的相同机制也可能导致正常组织的非预期靶向，特征为免疫相关不良事件（irAE）。认为既存自身免疫性疾病患者特别容易加重基础自身免疫性或诱导重度irAE。我们报告的第一例CPI相关的复发原发性膜性肾病（MN）的胸膜间皮瘤患者的免疫治疗。由于其靶向B淋巴细胞的特异性，利妥昔单抗被用于治疗原发性MN，期望这不会干扰从T细胞介导的抗肿瘤免疫中获得的益处。利妥昔单抗可有效治疗CPI相关的MN再激活，患者成功接受纳武利尤单抗再激发，维持稳定的肾功能和持续的临床抗肿瘤作用。虽然CPI导致的既存自身免疫性疾病的恶化是常见的，但通过理解具有癌症治疗目标的免疫抑制机制，可以合理地指导自身免疫性再激活的治疗。
The same mechanisms that mediate antitumor immunity from checkpoint inhibitors (CPIs) can also lead to unintended targeting of normal tissues, characterized as immune-related adverse events (irAEs). Those with pre-existing autoimmune disease are believed to be particularly vulnerable for exacerbating underlying autoimmunity or inducing severe irAEs. We report the first case of CPI-associated reactivation of primary membranous nephropathy (MN) in a patient with pleural mesothelioma responding to immunotherapy. Due to its specificity in targeting B-lymphocytes, rituximab was used to treat primary MN with the expectation that this would not interfere with the benefits gained from T cell-mediated antitumor immunity. Rituximab was effective in treating CPI-associated reactivation of MN, and the patient was successfully rechallenged with nivolumab and maintained stable kidney function and sustained clinical antitumor effect. While exacerbation of pre-existing autoimmune diseases from CPIs is common, therapy for autoimmune reactivation can be rationally directed by an understanding of the immunosuppressive mechanism with goals of cancer treatment.
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影响因子：
19.6
作者：
Cortazar FB;Marrone KA;Troxell ML;Ralto KM;Hoenig MP;Brahmer JR;Le DT;Lipson EJ;Glezerman IG;Wolchok J;Cornell LD;Feldman P;Stokes MB;Zapata SA;Hodi FS;Ott PA;Yamashita M;Leaf DE
通讯作者：
Leaf DE
影响因子：
16.6
作者：
Somasundaram R;Zhang G;Fukunaga-Kalabis M;Perego M;Krepler C;Xu X;Wagner C;Hristova D;Zhang J;Tian T;Wei Z;Liu Q;Garg K;Griss J;Hards R;Maurer M;Hafner C;Mayerhöfer M;Karanikas G;Jalili A;Bauer-Pohl V;Weihsengruber F;Rappersberger K;Koller J;Lang R;Hudgens C;Chen G;Tetzlaff M;Wu L;Frederick DT;Scolyer RA;Long GV;Damle M;Ellingsworth C;Grinman L;Choi H;Gavin BJ;Dunagin M;Raj A;Scholler N;Gross L;Beqiri M;Bennett K;Watson I;Schaider H;Davies MA;Wargo J;Czerniecki BJ;Schuchter L;Herlyn D;Flaherty K;Herlyn M;Wagner SN
通讯作者：
Wagner SN
影响因子：
10.9
作者：
Mamlouk, Omar;Selamet, Umut;Abudayyeh, Ala
通讯作者：
Abudayyeh, Ala
影响因子：
13.2
作者：
Bjorneklett, Rune;Vikse, Bjorn Egil;Iversen, Bjarne M.
通讯作者：
Iversen, Bjarne M.
通过癌症免疫疗法的膜性肾病复发。
影响因子：
4.6
作者：
Kim Y
通讯作者：
Kim Y