Late-onset nivolumab-mediated pneumonitis in a patient with melanoma and multiple immune-related adverse events
Late-onset nivolumab-mediated pneumonitis in a patient with melanoma and multiple immune-related adverse events
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DOI：
10.1097/cmr.0000000000000355
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发表时间：
2017-08-01
影响因子：
2.2
通讯作者：
Gogas, Helen
中科院分区：
文献类型：
--
作者：
Diamantopoulos, Panagiotis T.;Gaggadi, Maria;Gogas, Helen
PD-1抑制剂的免疫相关不良反应（AE）几乎可以影响所有器官，但皮肤、肠、肺、眼和肝脏是最常见的受影响器官。在这里，我们介绍了一名62岁的IIIC期黑色素瘤女性患者在辅助治疗中接受纳武利尤单抗治疗，随后出现甲状腺功能亢进症、甲状腺功能减退症、急性肝炎和肺炎。在肺炎出现前6个月，患者因急性肝炎停止了纳武利尤单抗治疗。文献中关于nivolumab停药后肺炎的信息很少，而大多数病例出现在治疗的前2.5个月。发生多种免疫相关AE的患者是一组特别关注的人群，因为确定影响患者对PD-1抑制剂免疫相关AE易感性的因素可能会导致更合理地使用这些药物。人类白细胞抗原单倍型和Fc受体多态性是相关研究的可能目标。
Immune-related adverse effects (AEs) of PD-1 inhibitors can affect almost every organ, but the skin, intestine, lung, eye, and liver are the most commonly affected organs. Here, we present the case of a 62-year-old female patient with stage IIIc melanoma treated with nivolumab in an adjuvant setting who sequentially developed hyperthyroidism, hypothyroidism, acute hepatitis, and pneumonitis. Six months before the emergence of pneumonitis, the patient had discontinued treatment with nivolumab because of acute hepatitis. Information on pneumonitis after nivolumab discontinuation in the literature is scarce, whereas most of the cases emerge during the first 2.5 months of treatment. Patients with multiple immune-related AEs comprise a group of special interest as the identification of factors affecting the susceptibility of patients to immune-related AEs of PD-1 inhibitors may lead to a more rational use of these drugs. Human leukocyte antigen haplotype and Fc receptor polymorphisms are possible targets of the relevant research.