Unique Cytologic Features of Thyroiditis Caused by Immune Checkpoint Inhibitor Therapy for Malignant Melanoma.
Unique Cytologic Features of Thyroiditis Caused by Immune Checkpoint Inhibitor Therapy for Malignant Melanoma.
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DOI：
10.1016/j.gendis.2017.11.002
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发表时间：
2018-03
期刊：
影响因子：
6.8
通讯作者：
Hodi FS
中科院分区：
文献类型：
--
作者：
Angell TE;Min L;Wieczorek TJ;Hodi FS
阻断免疫检查点分子以逆转癌症诱导的免疫抑制可以改善癌症患者的抗肿瘤免疫应答。靶向两种这样的分子，程序性细胞死亡蛋白1（PD-1）和细胞毒性T淋巴细胞相关蛋白4（CTLA-4）的单克隆抗体已经显示出在治疗晚期恶性肿瘤（包括转移性黑色素瘤）中的临床益处。这些免疫检查点抑制剂的不良反应包括免疫相关不良事件（irAE），其中最常见的是自身免疫性甲状腺炎。虽然甲状腺炎越来越多地认识到，有没有报告的病理结果发生在免疫治疗诱导的甲状腺炎。我们提出了一个免疫治疗引起的甲状腺炎，展示其独特的细胞病理学特征。一名患有转移性黑色素瘤的51岁女性患者在开始接受nivolumab（PD-1拮抗剂）+ipilimumab（CTLA-4拮抗剂）治疗后14天发现TSH抑制和游离甲状腺素浓度升高。根据超声检查结果进行甲状腺活检，细胞病理学显示独特的特征，包括大量的坏死细胞簇、淋巴细胞和CD 163阳性组织细胞。本病例报告了免疫检查点抑制剂相关甲状腺炎的细胞病理学特征。这些似乎是独特的发现，可能有助于为未来关于这种疾病的病理生理学和机制的研究提供信息。
Blockade of immune checkpoint molecules to reverse cancer-induced immune suppression can improve anti-tumor immune responses in cancer patients. Monoclonal antibodies targeting two such molecules, Programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte associated protein 4 (CTLA-4) have shown clinical benefit in the treatment of advanced malignancies, including metastatic melanoma. Adverse effects of these immune checkpoint inhibitors include immune-related adverse events (irAE), of which one of the most common is autoimmune thyroiditis. Though thyroiditis is increasingly recognized, there are no reports of the pathological findings that occur in immunotherapy-induced thyroiditis. We present a case of immunotherapy-induced thyroiditis demonstrating its unique cytopathologic features. A 51-year-old woman with metastatic melanoma was found to have a suppressed TSH and elevated free thyroxine concentration 14 days after starting treatment with nivolumab (PD-1 antagonist) plus ipilimumab (CTLA-4 antagonist) therapy. A thyroid biopsy was performed based on ultrasound findings and cytopathology revealed unique features including abundant clusters of necrotic cells, lymphocytes and CD163-positive histiocytes. This case reports cytopathologic features found in immune checkpoint inhibitor related thyroiditis. These appear to be unique findings and may help inform future research regarding the pathophysiology and mechanisms of this condition.
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DOI：
10.1056/nejmoa1504030
发表时间：
2015-07-02
期刊：
The New England journal of medicine
影响因子：
--
作者：
Larkin J;Chiarion-Sileni V;Gonzalez R;Grob JJ;Cowey CL;Lao CD;Schadendorf D;Dummer R;Smylie M;Rutkowski P;Ferrucci PF;Hill A;Wagstaff J;Carlino MS;Haanen JB;Maio M;Marquez-Rodas I;McArthur GA;Ascierto PA;Long GV;Callahan MK;Postow MA;Grossmann K;Sznol M;Dreno B;Bastholt L;Yang A;Rollin LM;Horak C;Hodi FS;Wolchok JD
通讯作者：
Wolchok JD
DOI：
10.1056/nejmoa1003466
发表时间：
2010-08-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hodi FS;O'Day SJ;McDermott DF;Weber RW;Sosman JA;Haanen JB;Gonzalez R;Robert C;Schadendorf D;Hassel JC;Akerley W;van den Eertwegh AJ;Lutzky J;Lorigan P;Vaubel JM;Linette GP;Hogg D;Ottensmeier CH;Lebbé C;Peschel C;Quirt I;Clark JI;Wolchok JD;Weber JS;Tian J;Yellin MJ;Nichol GM;Hoos A;Urba WJ
通讯作者：
Urba WJ
影响因子：
20.3
作者：
Schaer, DJ;Schaer, CA;Schaffner, A
通讯作者：
Schaffner, A
影响因子：
5.8
作者：
Orlov, Steven;Salari, Farnaz;Walfish, Paul G.
通讯作者：
Walfish, Paul G.