Late-Onset Immunotherapy Toxicity and Delayed Autoantibody Changes: Checkpoint Inhibitor-Induced Raynaud's-Like Phenomenon
Late-Onset Immunotherapy Toxicity and Delayed Autoantibody Changes: Checkpoint Inhibitor-Induced Raynaud's-Like Phenomenon
复制标题
DOI：
10.1634/theoncologist.2019-0666
复制
发表时间：
2020-05-01
期刊：
影响因子：
5.8
通讯作者：
Gerber, David E.
中科院分区：
文献类型：
--
作者：
Khan, Shaheen;von Itzstein, Mitchell S.;Gerber, David E.
免疫检查点抑制剂(ICI)诱导的免疫相关不良事件(IrAEs)几乎可影响任何器官系统，并可在治疗过程中的任何时间点发生。自身抗体分析可以提供对这些事件的机制、性质和时间的洞察。我们报告了一例接受联合免疫治疗的患者因ICI导致的迟发性雷诺样现象。1例53岁晚期非小细胞肺癌患者接受了联合抗细胞毒T淋巴细胞抗原4和抗程序性死亡1ICI治疗。她早期(4个月时患脑垂体炎)和晚期(雷诺氏病20个月时)出现气房。124种自身抗体的纵向评估与毒性相关。虽然自身抗体水平在治疗的前18个月基本稳定，但在雷诺氏病发生前不久，观察到多种自身抗体显著增加。这一案例突出了延迟自身免疫毒性的可能性，并为这些事件的动态性质提供了潜在的生物学见解。
Immune checkpoint inhibitor (ICI)-induced immune-related adverse events (irAEs) may affect almost any organ system and occur at any point during therapy. Autoantibody analysis may provide insight into the mechanism, nature, and timing of these events. We report a case of ICI-induced late-onset Raynaud's-like phenomenon in a patient receiving combination immunotherapy. A 53-year-old woman with advanced non-small lung cancer received combination anti-cytotoxic T-lymphocyte antigen 4 and anti-programmed death 1 ICI therapy. She developed early (hypophysitis at 4 months) and late (Raynaud's at >20 months) irAEs. Longitudinal assessment of 124 autoantibodies was correlated with toxicity. Although autoantibody levels were generally stable for the first 18 months of therapy, shortly before the development of Raynaud's, a marked increase in multiple autoantibodies was observed. This case highlights the potential for delayed autoimmune toxicities and provides potential biologic insights into the dynamic nature of these events.