在晚期发病的尼沃卢马布诱导的低炎中,晚期发病的食道状细胞癌在晚期发病的食道状细胞癌中
Oumaima Lamsyah1,2,3, Intissar Belrhali2, Yousra Al Harrak1
1Department of Medical Oncology, National Institute of Oncology, Rabat, MAR.
Cureus
|May 7, 2025
概括
像尼沃卢马布这样的免疫检查点抑制剂 (ICI) 可以导致罕见的脑下垂体疾病 - - 脑下垂体炎. 这一案例强调了在晚期食道癌患者中对延迟内分泌irAEs的监测需要保持警.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 内分泌学 在内分泌学.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症疗法,特别是用nivolumab治疗晚期食道状细胞癌 (ESCC) 的癌症.
- 免疫相关的不良事件 (irAEs),包括缺血炎,可以发生在ICI.
- 低血糖炎后抗编程细胞死亡蛋白1 (PD-1) 治疗是罕见的,由于非特异性症状和正常成像,在诊断上具有挑战性.
研究的目的:
- 报告一个晚发性低血位炎的独特病例,该病例发生在治疗nivolumab的高级ESCC患者身上.
- 强调诊断挑战和临床影响的延迟下炎.
- 强调内分泌监测和接受ICI的患者多学科护理的重要性.
主要方法:
- 一个68岁的男性患有晚期ESCC的病例报告.
- 用尼沃卢马布治疗21个周期.
- 评估症状,包括疲劳,厌食症,减肥,低血症和上腺功能不全.
- 下垂体磁共振成像 (MRI).
- 开始使用皮替代疗法.
主要成果:
- 患者在21次尼沃卢马布治疗周期后发展出晚发性低血清炎.
- 确定了严重的低血和上腺功能不充分.
- 下垂体MRI显示没有结构异常.
- 随着皮的使用,症状有所改善,但由于上腺功能不全和瘤进展,尼沃卢马布的治疗已停止.
结论:
- 晚期发病的低血清炎是一种罕见但关键的与抗PD-1疗法相关的irAE.
- 持续的临床警和主动的内分泌监测对于ICI患者至关重要.
- 及时识别和干预对于管理可能危及生命的并发症和确保生活质量至关重要.
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