Edmondson Lindsay A, Smith Leticia V, Mallik Alka
Seton Healthcare Family, Austin, TX, USA.
J Oncol Pharm Pract. 2017 Dec;23(8):629-634. doi: 10.1177/1078155216667636. Epub 2016 Sep 8.
The programmed-death-1 inhibitors selectively block programmed-death-1 interaction with its receptor, which restores active T-cell response directed at tumor cells, inducing an anti-tumor effect. This nonspecific activation of the immune system can also lead to a wide spectrum of side effects. Nivolumab has been used effectively to prolong survival in patients with metastatic melanoma and is recommended as a category 1 agent for systemic therapy in metastatic or unresectable melanoma per the National Comprehensive Cancer Network guidelines. We present a case of a 64-year-old woman who began nivolumab therapy for metastatic melanoma. After six doses of nivolumab therapy, the patient experienced generalized hypopigmentation on her face, chest, back, arms, and lower extremities. Although vitiligo has been reported in as many as 10.7% of patients undergoing nivolumab therapy in some clinical trials, we believe this is the first case to describe the progression of nivolumab-induced vitiligo in a metastatic melanoma patient. This case provides significant insight into the onset, symptoms, development, and treatment options for patients experiencing vitiligo as a result of nivolumab therapy.
程序性死亡蛋白1（PD-1）抑制剂可选择性阻断PD-1与其受体的相互作用，从而恢复针对肿瘤细胞的活性T细胞反应，诱导抗肿瘤效应。免疫系统的这种非特异性激活也可导致广泛的副作用。纳武单抗已被有效地用于延长转移性黑色素瘤患者的生存期，并且根据美国国立综合癌症网络指南，它被推荐作为转移性或不可切除黑色素瘤全身治疗的1类药物。我们报告一例64岁女性患者，她开始接受纳武单抗治疗转移性黑色素瘤。在接受六剂纳武单抗治疗后，患者面部、胸部、背部、手臂和下肢出现全身性色素减退。尽管在一些临床试验中，高达10.7%接受纳武单抗治疗的患者报告出现白癜风，但我们认为这是第一例描述转移性黑色素瘤患者中纳武单抗诱导的白癜风进展情况的病例。该病例为因纳武单抗治疗而出现白癜风的患者的发病、症状、发展及治疗选择提供了重要见解。
