多系统免疫相关的不良事件在联合 ipilimumab-nivolumab 与随后的疾病进展:一个病例报告
Elsa Jonsdottir1, Ivan Arni Robertsson1, Agust Hilmarsson2
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Immunotherapy
|December 17, 2025
概括
这份病例报告详细介绍了一名转移性黑色素瘤患者,在治疗伊皮姆巴-尼沃姆巴后,他经历了严重的,同时发生的免疫检查点抑制剂 (ICI) 相关的低血清炎和结肠炎. 患者进一步发展出多神经病变,并最终死于进展性疾病而没有瘤回归.
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:
- 转移性黑色素瘤构成了重大治疗挑战.
- 免疫检查点抑制剂 (ICI),如伊皮利马布和尼沃马布,提供治疗选择.
- 免疫相关不良事件 (irAEs) 是已知的ICI治疗并发症.
研究的目的:
- 报告一例罕见的同时发生的低体位炎,大肠炎和多神经病变的病例,该病例发生在接受伊皮利姆巴-尼沃姆巴治疗的患者身上.
- 为了突出严重的,多系统的irAEs的潜力,尽管停止治疗和免疫抑制.
- 强调需要对转移性黑色素瘤患者的irAEs进行警的患者监测.
主要方法:
- 一个70岁的患有转移性黑色素瘤的病例报告.
- 使用联合伊皮利穆马布-尼沃卢穆马布治疗的治疗.
- 通过CT扫描监测与免疫相关的不良事件 (irAEs) 和疾病进展.
主要成果:
- 同时的伊皮利木巴-尼沃木巴相关的阴囊炎和结肠炎在两次循环后发展.
- 类固醇耐火性结肠炎需要重新入院.
- 与IVIG治疗的ICI相关的多神经病变的后续发展.
- 在CT扫描中观察到的渐进性肝病变生长,没有瘤回归.
- 患者死于进展性转移性黑色素瘤.
结论:
- 这种病例表明多系统的irAEs (低血位炎,大肠炎,多神经病变) 不寻常的组合,没有治疗反应.
- 持续监测新的irAEs至关重要,即使在ICI停止和开始免疫抑制治疗后也是如此.
- 在接受转移性黑色素瘤组合免疫治疗的患者中,对严重的免疫相关不良事件的警至关重要.
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