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两名转移性黑色素瘤合并系统性自身免疫疾病患者接受伊匹单抗和白细胞介素-2治疗取得成功。

Successful treatment with Ipilimumab and Interleukin-2 in two patients with metastatic melanoma and systemic autoimmune disease.

作者信息

Pedersen Magnus, Andersen Rikke, Nørgaard Peter, Jacobsen Søren, Thielsen Peter, Thor Straten Per, Svane Inge Marie

机构信息

Department of Haematology and Oncology, Center for Cancer Immune Therapy, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.

出版信息

Cancer Immunol Immunother. 2014 Dec;63(12):1341-6. doi: 10.1007/s00262-014-1607-y. Epub 2014 Sep 17.


DOI:10.1007/s00262-014-1607-y
PMID:25227926
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11028899/
Abstract

Two patients were treated with immunotherapy for metastatic malignant melanoma (MM) despite suffering from systemic autoimmune disease, i.e., ulcerative colitis (UC) and Behcets disease (BD), respectively. Both patients benefitted from the treatment. The patient with UC achieved partial remission of all measurable parameters after treatment with Ipilimumab, while the patient with BD achieved a complete remission of MM after treatment with Interleukin-2 (IL-2) and Interferon-α (IFN-α). Moreover, no aggravation of symptoms related to the autoimmune diseases was seen during treatment, in contrast, clinical indications of improvement were observed. These two cases illustrate that the presence of autoimmune disease does not necessarily predict increased autoimmune toxicity in connection with immunotherapy. They also raise the question of whether autoimmune disease should continue to be an absolute exclusion criterion for treatment of MM with immunotherapy. Consequently, given the poor prognosis of refractory MM, immunotherapies need to be taken into consideration even in cases of autoimmune comorbidity due to the potential long-term benefit that these therapies offer to MM patients.

摘要

两名转移性恶性黑色素瘤(MM)患者分别患有系统性自身免疫性疾病,即溃疡性结肠炎(UC)和白塞病(BD),但仍接受了免疫治疗。两名患者均从治疗中获益。患有UC的患者在接受伊匹单抗治疗后,所有可测量参数均实现部分缓解,而患有BD的患者在接受白细胞介素-2(IL-2)和干扰素-α(IFN-α)治疗后,MM实现完全缓解。此外,治疗期间未观察到与自身免疫性疾病相关的症状加重,相反,观察到症状改善的临床迹象。这两个病例表明,自身免疫性疾病的存在不一定预示着免疫治疗会增加自身免疫毒性。它们还提出了一个问题,即自身免疫性疾病是否应继续作为免疫治疗MM的绝对排除标准。因此,鉴于难治性MM的预后较差,即使在存在自身免疫合并症的情况下,也需要考虑免疫治疗,因为这些疗法可能会给MM患者带来长期益处。

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Successful treatment with Ipilimumab and Interleukin-2 in two patients with metastatic melanoma and systemic autoimmune disease.

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[6]
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[10]
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本文引用的文献

[1]
Immunological and biological changes during ipilimumab treatment and their potential correlation with clinical response and survival in patients with advanced melanoma.

Cancer Immunol Immunother. 2014-4-3

[2]
Melanoma in 2013: Melanoma--the run of success continues.

Nat Rev Clin Oncol. 2014-2

[3]
Myeloid-derived suppressor cells predict survival of patients with advanced melanoma: comparison with regulatory T cells and NY-ESO-1- or melan-A-specific T cells.

Clin Cancer Res. 2013-12-9

[4]
Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines.

J Clin Pathol. 2013-9-2

[5]
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Nat Rev Clin Oncol. 2013-8-27

[6]
Diarrhoea in a patient with metastatic melanoma: Ipilimumab ileocolitis treated with infliximab.

World J Gastrointest Pharmacol Ther. 2013-8-6

[7]
Behçet's syndrome: facts and controversies.

Clin Dermatol. 2013

[8]
Ulcerative colitis.

BMJ. 2013-2-5

[9]
The price of tumor control: an analysis of rare side effects of anti-CTLA-4 therapy in metastatic melanoma from the ipilimumab network.

PLoS One. 2013-1-14

[10]
Behcet's Syndrome.

Drugs. 2012-12-3

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