转移性细胞癌中免疫疗法诱导的不良事件:快速反应和复杂挑战的案例
João Pedroso Lima1, Ana Marta Ferreira1, Vasco Quaresma1
1Urology and Renal Transplantation Department, Hospital and University Centre of Coimbra, Praceta Professor Mota Pinto, 3004-561, Coimbra, Portugal.
本案例研究强调了一名患有晚期清晰细胞癌的患者,他使用苏尼提尼布 (Sunitinib) 控制了疾病,随后使用尼沃卢马布 (Nivolumab) 完成了转移性解脱. 随后的卡博赞提尼布治疗在疾病复发后实现了部分反应.
科学领域:
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫治疗是一种免疫疗法.
背景情况:
- 一个55岁的女性呈现出呼吸不良和左侧大脏清细胞癌与广泛的转移.
- 最初的治疗包括苏尼提尼布,它是有效的,但受到严重皮肤炎的限制.
研究的目的:
- 描述患有晚期清晰细胞细胞癌的患者的临床过程和治疗结果.
- 为了说明与治疗相关的毒性和疾病复发的挑战和管理.
主要方法:
- 患者接受了连续的全身疗法,包括苏尼提尼布,尼沃卢马布和卡博赞提尼布.
- 治疗涉及手术干预 (腎切除术) 和免疫相关不良事件的治疗.
主要成果:
- 尼沃卢马布治疗实现了转移性疾病的完全消失,从而实现了切除术.
- 经过切除术后,患者患上了类似Vogt-Koyanagi-Harada的疾病,需要停止使用Nivolumab并接受皮质类固醇治疗.
- 经过24个月的无病间隔后,出现了逆侧病变和肺转移的复发,对卡博赞提尼布有部分反应.
结论:
- 用苏尼提尼布,尼沃卢马布和卡博赞提尼布进行序列治疗可以有效地管理先进的清晰细胞细胞癌.
- 在免疫治疗期间,仔细监测和管理与免疫相关的不良事件至关重要.
- 疾病复发需要重新评估治疗策略.
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