在用 pembrolizumab 进行化疗免疫治疗期间有毒的表皮解
Araceli Iglesias-Santamaría1, Nerea Rodríguez González2
1Oncology Pharmacy Department, Hospital Universitario Lucus Augusti, Lugo, Spain.
概括
免疫检查点抑制剂 (ICI) 与化疗相结合可以引起严重的皮肤反应,如有毒表皮解 (TEN). 早期识别和多学科护理对于管理这些罕见但危及生命的免疫相关不良事件至关重要.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 改善了晚期癌症的结果.
- 将ICI与化疗相结合会增加严重免疫相关不良事件 (irAEs) 的风险.
- 皮肤毒性,包括罕见但危及生命的反应,是ICI治疗的一个问题.
研究的目的:
- 报告一种对组合免疫疗法的二次性有毒表皮解 (TEN) 病例.
- 突出早期识别和多学科管理严重ICI诱导的皮肤毒性的重要性.
主要方法:
- 一名69岁的男性患有第四期状细胞肺癌,接受了卡博普拉丁,帕克利塔塞尔和潘布罗利祖马布.
- 患者在第三个周期后出现了广泛的状病变,被诊断为TEN.
- 治疗包括药物停用,支持性护理,全身皮质类固醇和etanercept.
主要成果:
- 患者出现了有毒的表皮解体 (TEN),覆盖了90%以上的身体表面积.
- 治疗包括停止抗瘤药物治疗,全身皮质类固醇和乙.
- 患者在16天后出院,皮肤重新上皮化.
结论:
- 毒性表皮解 (TEN) 是免疫检查点抑制剂 (ICI) 的一种罕见,严重的不良反应.
- 迅速识别,药物停用,支持性护理和多学科管理是必不可少的.
- 像伊坦塞普特这样的TNF-α抑制剂可能是有益的,需要进一步调查.
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