Anti-PD1 following ipilimumab for mucosal melanoma: durable tumor response associated with severe hypothyroidism and rhabdomyolysis.
Anti-PD1 following ipilimumab for mucosal melanoma: durable tumor response associated with severe hypothyroidism and rhabdomyolysis.
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DOI：
10.1158/2326-6066.cir-13-0146
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发表时间：
2014-01
影响因子：
10.1
通讯作者：
Hodi FS
中科院分区：
文献类型：
--
作者：
Min L;Hodi FS
抗程序性死亡1 （anti-PD1）的全人源单克隆抗体在治疗许多晚期恶性肿瘤方面显示出巨大的前景。虽然抗细胞毒性t淋巴细胞抗原（CTLA4）治疗的炎症不良事件已经得到了很好的描述，但抗pd1治疗的不良反应范围仍然相对有限。在这里，我们报告了一位晚期粘膜黑色素瘤患者，他接受了四剂MK-3475，一种针对PD1的全人源单克隆抗体，并经历了持久的接近完全的反应，但出现了严重的甲状腺功能减退、横纹肌溶解和急性肾损伤。据我们所知，这是第一例对抗pd1治疗有反应的晚期粘膜黑色素瘤患者。随着抗pd1在多种肿瘤中具有良好的抗肿瘤作用，我们预计越来越多的患者将接受抗pd1治疗。在接受抗pd1治疗的患者中，识别罕见的不良事件，如CK水平升高和甲状腺疾病是很重要的。
Treatment with fully human monoclonal antibodies against programmed death 1 (anti-PD1) have demonstrated great promise for the treatment of a number of advanced malignancies. While inflammatory adverse events have been well-described with anti-Cytotoxic T-Lymphocyte Antigen (CTLA4) therapy, experience with the range of adverse effects of anti-PD1 remains comparatively limited. Here, we report a patient with advanced mucosal melanoma who received four doses of MK-3475, a fully human monoclonal antibody against PD1, and experienced a durable near complete response, but developed severe hypothyroidism, rhabdomyolysis and acute kidney injury. To our knowledge, this is the first case reportedof a patient with advanced mucosal melanoma who responded to anti-PD1 therapy. With the promising antitumor effects of anti-PD1 in a wide array of tumors, we expect an increasing number of patients to be exposed to anti-PD1 therapies. Recognition of infrequent presentations of adverse events such as elevated CK levels and thyroid disorders in patients who receive anti-PD1 therapy is important.