布罗利祖马布的脏免疫相关不良事件被佩米特雷克塞德掩盖
Koya Nagase1, Yukari Murai1, Waka Yokoyama-Kokuryo2
1Department of Nephrology, Chubu Rosai Hospital, Japan.
Internal medicine (Tokyo, Japan)
|May 31, 2023
概括
这一案例凸显出,将化疗与免疫检查点抑制剂结合起来,可能会导致损伤. 早期检测和活检对于在癌症治疗期间诊断药物诱导的毒性至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 化学疗法和免疫检查点抑制剂的同时使用越来越多地用于晚期肺腺癌.
- 药物诱导性毒性是一种与化疗剂和免疫检查点抑制剂相关的潜在不良事件.
- 在接受组合治疗的患者中,区分损伤的不同原因可能是具有挑战性的.
研究的目的:
- 报告患者患有严重损伤的病例,患者接受了佩米特雷克斯德,卡博普拉丁和潘布罗利祖马布治疗,用于治疗第四阶段肺腺癌.
- 为了调查功能恶化的潜在原因,尽管停止了pemetrexed.
- 强调在接受组合免疫疗法和化疗的患者中考虑同时产生的药物诱导性毒性的重要性.
主要方法:
- 一个60多岁的日本妇女患有第四阶段肺腺癌的病例报告.
- 进行了连续的活检以评估损伤.
- 审查了包括治疗史和实验室发现在内的临床数据.
主要成果:
- 患者在开始服用佩米特雷克斯德,卡博普拉丁和潘布罗利祖马布9周后出现损伤.
- 最初的脏活检显示慢性管间隙损伤,与佩米特雷克斯德诱导的脏病相一致,导致佩米特雷克斯德的戒断.
- 尽管停止了佩米雷克塞德,损伤进展,重复活检显示出严重的急性管间炎,暗示着布罗利祖马布诱导的免疫相关不良事件 (irAE).
结论:
- 这一案例强调了化学疗法和免疫检查点抑制剂同时产生的毒性潜力.
- 在初始治疗修改后功能恶化表明正在进行的免疫相关不良事件.
- 在管理接受组合癌症治疗的患者时,必须仔细监测,通过活检及时诊断,并考虑联合药物效应.
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