Sibaud Vincent, David Isabelle, Lamant Laurence, Resseguier Sarah, Radut Roxana, Attal Justine, Meyer Nicolas, Delord Jean-Pierre
Departments of aDermatology bRadiation Oncology cPathology dClinical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France.
Melanoma Res. 2015 Dec;25(6):555-8. doi: 10.1097/CMR.0000000000000191.
The combination of localized radiotherapy and immune checkpoint inhibitors represents a promising therapeutic strategy for various cancers, including metastatic melanoma. Radiation therapy may enhance tumor antigen presentation and cytokine release, which may optimize the systemic antitumor immune response induced by these immunotherapeutic antibodies, with a potential delayed abscopal effect. However, clinical experience of using immune checkpoint inhibitors with concurrent radiotherapy remains scarce. We report here for the first time a case suggestive of acute skin radiosensitization induced by pembrolizumab, with a suggestive time relationship between the completion of ionizing radiation, drug administration, and rapid onset of the skin reaction. This suggests that radiation therapy may also interact rapidly with anti-programmed-death 1 antibodies. Therefore, caution should be exercised when prescribing this combination therapy in advanced cancers.
局部放疗与免疫检查点抑制剂联合使用是包括转移性黑色素瘤在内的多种癌症的一种有前景的治疗策略。放射治疗可能增强肿瘤抗原呈递和细胞因子释放，这可能优化这些免疫治疗性抗体诱导的全身抗肿瘤免疫反应，并具有潜在的延迟远隔效应。然而，同时使用免疫检查点抑制剂和放疗的临床经验仍然匮乏。我们在此首次报告一例提示帕博利珠单抗诱导急性皮肤放射增敏的病例，电离辐射结束、药物给药与皮肤反应快速发作之间存在提示性的时间关系。这表明放疗也可能与抗程序性死亡1抗体迅速相互作用。因此，在晚期癌症中开具这种联合治疗处方时应谨慎。
