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Shirly J Mysler¹, Florencia Perazzo², Pablo Mandó²

¹Departamento de Oncología, Hospital CEMIC, Buenos Aires, Argentina. E-mail:

|June 28, 2023

概括

免疫检查点抑制剂可以在细胞癌患者中引起严重的自身免疫脑炎. 及时的皮质类固醇治疗导致完全康复和持续的癌症反应,即使在停止免疫治疗后.

科学领域:

在瘤学瘤学.
免疫学免疫学免疫学
神经学神经学

背景情况:

免疫检查点抑制剂 (ICI) 改善了IV期细胞癌 (RCC) 的存活率.
免疫相关不良事件 (IRAE),包括自身免疫性脑炎 (AE),是ICI的重大并发症.
最佳管理ICI诱导的AE和随后的抗瘤反应仍然不清楚.

研究的目的:

在接受尼沃卢马布治疗的第四阶段RCC患者中报告自身免疫脑炎病例.
讨论这种严重的中枢神经系统IRAE的临床管理.
为了评估AE治疗和免疫治疗停止后的瘤疾病反应.

主要方法:

一个67岁的女性患有IV期RCC的病例报告,该病例在nivolumab.
用高剂量的皮质类固醇治疗自身免疫性脑炎.
监测神经恢复和瘤疾病状态.

主要成果:

患者在nivolumab治疗期间发生了自身免疫性脑炎.
神经症状在高剂量皮质类固醇治疗5天内显著改善.
尽管停止了尼沃卢马布治疗,但患者仍取得了持续的抗瘤反应.

结论:

自身免疫性脑炎是一种罕见但严重的IRAE,与RCC中的ICI相关.
高剂量的皮质类固醇在治疗ICI诱导的自身免疫性脑炎方面是有效的.
由于IRAE而停止ICI可能不一定会影响长期抗瘤疗效.

关键词:

不良事件不良事件不良事件脑炎是一种脑炎.免疫疗法免疫疗法这就是尼沃卢马布 (nivolumab).

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