尼沃卢马布诱导的免疫介导性结肠炎局限于距离结肠:治疗七年
Christian J Nassif1, Imad I Nassif2, Mouna Todorov3
1Medicine, Kansas City University of Medicine and Biosciences, Kansas City, USA.
Cureus
|November 25, 2024
概括
尼沃卢马布是一种癌症免疫疗法,很少引起免疫媒介性结肠炎. 这一案例突出了一个罕见的结肠炎的例子,类似于性结肠炎,在肺癌治疗nivolumab后七年发生在远端结肠中.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 尼沃卢马布是一种针对PD-1的免疫检查点抑制剂,用于癌症治疗.
- 免疫媒介性结肠炎 (IMC) 是一种罕见但已知的nivolumab的不良影响.
- 免疫疗法的长期不良影响越来越被认可.
研究的目的:
- 报告一种罕见的尼沃卢马布诱导的免疫媒介性结肠炎病例.
- 描述晚发,远部局部化的IMC的临床表现和内镜发现.
- 强调考虑免疫疗法副作用的重要性,即使在长期治疗后也是如此.
主要方法:
- 一个66岁的男性患有转移性肺腺癌的病例报告.
- 临床病史,治疗细节 (7年服用尼沃卢马布) 和患者报告的症状 (,血性腹) 的审查.
- 结肠镜与活检评估远端结肠的变化.
主要成果:
- 患者在接受了尼沃卢马布治疗七年后出现了暗示大肠炎的症状.
- 结肠镜检查显示,性结肠炎类似的变化仅限于结肠的远距离25厘米.
- 组织病理学检查证实了UC类变化,与免疫介导性结肠炎一致.
结论:
- 尼沃卢马布可以诱导类似于性结肠炎的免疫媒介性结肠炎.
- 晚发和远部局部化的IMC是罕见的,但可能的不良事件.
- 这一案例强调了需要对免疫治疗相关的胃肠道毒性保持警,无论治疗持续时间如何.
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