Yun Seongseok, Vincelette Nicole D, Mansour Iyad, Hariri Dana, Motamed Sara
Department of Medicine, University of Arizona, Tucson, AZ 85721, USA.
Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA.
Case Rep Oncol Med. 2015;2015:794842. doi: 10.1155/2015/794842. Epub 2015 Mar 30.
Metastatic cutaneous melanoma has poor prognosis with 2-year survival rate of 10-20%. Melanoma cells express various antigens including gp100, melanoma antigen recognized by T cells 1 (MART-1), and tyrosinase, which can induce immune-mediated anticancer response via T cell activation. Cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) is an immune check point molecule that negatively regulates T cell activation and proliferation. Accordingly, recent phase III clinical trials demonstrated significant survival benefit with ipilimumab, a human monoclonal antibody (IgG1) that blocks the interaction of CTLA-4 with its ligands. Since the efficacy of ipilimumab depends on T cell activation, it is associated with substantial risk of immune mediated adverse reactions such as colitis, hepatitis, thyroiditis, and hypophysitis. We report the first case of late onset pericarditis and cardiac tamponade associated with ipilimumab treatment in patient with metastatic cutaneous melanoma.
转移性皮肤黑色素瘤预后较差，2年生存率为10%-20%。黑色素瘤细胞表达多种抗原，包括糖蛋白100、T细胞识别的黑色素瘤抗原1（MART-1）和酪氨酸酶，这些抗原可通过T细胞激活诱导免疫介导的抗癌反应。细胞毒性T淋巴细胞相关抗原4（CTLA-4）是一种免疫检查点分子，可负向调节T细胞的激活和增殖。因此，最近的III期临床试验表明，伊匹单抗（一种阻断CTLA-4与其配体相互作用的人单克隆抗体（IgG1））具有显著的生存获益。由于伊匹单抗的疗效取决于T细胞激活，它与免疫介导的不良反应（如结肠炎、肝炎、甲状腺炎和垂体炎）的重大风险相关。我们报告了首例与伊匹单抗治疗转移性皮肤黑色素瘤患者相关的迟发性心包炎和心脏压塞病例。
