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尼沃卢马布诱导的耐火性出血性胃炎和双炎需要多模式生物治疗

Roney Shibu¹, Kayla Scully², Waled Mohsen³

¹Royal Brisbane & Women's Hospital, Brisbane, Australia.

ACG case reports journal

|August 8, 2025

概括

免疫检查点抑制剂可以导致罕见但严重的上部胃肠道问题,如出血性胃炎. 这一案例凸显了对耐火病例的综合疗法 (包括维多利祖马布) 的需要.

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:

免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗,导致免疫相关不良事件 (irAEs) 的增加.
上部胃肠道的irrAEs,如胃炎和十二指肠炎,不常见,但可能是严重的和危及生命的.
这些irAEs的多样化呈现给诊断和治疗带来了挑战.

研究的目的:

报告尼沃卢马布治疗后发生的严重出血性胃炎和十二指肠炎的罕见病例.
讨论与这种罕见的irAE相关的诊断和治疗挑战.
评估多种药物治疗策略的疗效.

主要方法:

一名接受尼沃卢马布治疗的III期黑色素瘤患者患有严重的出血性胃炎和十二指肠炎.
开始用潘托普拉,类固醇和因弗利克西马布治疗是无效的.
韦多利祖马布被添加到治疗方案中,随后是长期的因弗利西马布治疗.

主要成果:

患者在尼沃卢马布治疗后两个月出现了严重的出血性胃炎和十二指肠炎.
这种情况对最初的治疗不耐药.
添加vedolizumab和随后的infliximab治疗导致了完全的临床和生化缓解.
在停止免疫调节疗法后的12个月随访期间没有观察到复发.

结论:

严重的上部胃肠道irrAEs,包括出血性胃炎和十二指肠炎,可能发生在nivolumab治疗后.
免疫调节剂的组合,包括vedolizumab和infliximab,可以有效地管理耐火病例.
在这些罕见但严重的免疫相关不良事件中,长期的因弗利西马布治疗可以实现持续缓解.

关键词:

十二指甲炎是什么意思胃炎是一种胃炎.这就是Infliximab的价值.这就是尼沃卢马布 (nivolumab).我已经看到了Vedolizumab.

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