Case Report: Immune Checkpoint Inhibitor-Induced Exuberant Tumor Inflammation With Accelerated Clinical Deterioration in Metastatic Renal Cell Carcinoma.
Case Report: Immune Checkpoint Inhibitor-Induced Exuberant Tumor Inflammation With Accelerated Clinical Deterioration in Metastatic Renal Cell Carcinoma.
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DOI：
10.3389/fonc.2021.679177
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发表时间：
2021
影响因子：
4.7
通讯作者：
George S
中科院分区：
文献类型：
--
作者：
Gopalakrishnan D;Jain RK;Herbst L;Sikorski M;Mandava S;Azabdaftari G;Xu B;LeVea C;Robillard K;Ernstoff MS;George S
免疫检查点抑制剂（ICIs）彻底改变了癌症治疗。 Nivolumab 是一种抗 PD-1 单克隆抗体，可显着改善晚期肾细胞癌 (RCC) 的总体生存率。然而，ICIs 很少会引发大规模炎症，这种现象的特点是放射学肿瘤生长迅速加速，其背后的机制很大程度上尚不清楚。我们报告了三名转移性肾细胞癌患者，他们在接受纳武单抗治疗后经历了快速的影像学进展和临床恶化。然而，尽管有放射学进展的证据，但组织学分析显示没有存活的癌症。相反，如先前在 ICI 诱导的假性进展患者中所描述的，注意到广泛的坏死和淋巴组织细胞浸润。基于这些观察结果，我们假设旺盛的抗肿瘤炎症反应可能会导致某些 ICI 诱导的放射学进展患者出现不良临床结果。纳入肿瘤活检的前瞻性研究可能会对这种罕见现象有更多的了解。
Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. Nivolumab, an anti-PD-1 monoclonal antibody, markedly improved overall survival in advanced renal cell carcinoma (RCC). However, ICIs can rarely trigger massive inflammation, a phenomenon characterized by rapid acceleration in radiographic tumor growth, the mechanisms underlying which are largely unknown. We report three patients with metastatic RCC who experienced rapid radiographic progression and clinical deterioration following treatment with nivolumab. However, histological analysis revealed no viable cancer despite the evidence of radiological progression. Instead, extensive necrosis and lymphohistiocytic infiltration were noted, as described previously in patients with ICI-induced pseudoprogression. Based on these observations, we postulate that exuberant antitumor inflammatory responses may contribute to adverse clinical outcomes in some patients with ICI-induced radiographic progression. Prospective studies incorporating tumor biopsies may shed more light on this rare phenomenon.
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影响因子：
20.4
作者：
Rocha, Pedro;Hardy-Werbin, Max;Arriola, Edurne
通讯作者：
Arriola, Edurne
影响因子：
5.3
作者：
Tanizaki, Junko;Hayashi, Hidetoshi;Nakagawa, Kazuhiko
通讯作者：
Nakagawa, Kazuhiko
Nivolumab对超出进展的转移性肾细胞癌患者的安全性和功效：对随机临床试验的亚组分析。
影响因子：
28.4
作者：
George S;Motzer RJ;Hammers HJ;Redman BG;Kuzel TM;Tykodi SS;Plimack ER;Jiang J;Waxman IM;Rini BI
通讯作者：
Rini BI
影响因子：
6.2
作者：
Motzer RJ;Escudier B;George S;Hammers HJ;Srinivas S;Tykodi SS;Sosman JA;Plimack ER;Procopio G;McDermott DF;Castellano D;Choueiri TK;Donskov F;Gurney H;Oudard S;Richardet M;Peltola K;Alva AS;Carducci M;Wagstaff J;Chevreau C;Fukasawa S;Tomita Y;Gauler TC;Kollmannsberger CK;Schutz FA;Larkin J;Cella D;McHenry MB;Saggi SS;Tannir NM
通讯作者：
Tannir NM
影响因子：
3.2
作者：
Hwang, Inhwan;Park, Inkeun;Lee, Jae Lyun
通讯作者：
Lee, Jae Lyun