Diamantopoulos Panagiotis T, Gaggadi Maria, Kassi Eva, Benopoulou Olga, Anastasopoulou Amalia, Gogas Helen
aFirst Department of Internal Medicine, National and Kapodistrian University of Athens bDepartment of Pneumology, Laikon General Hospital, Athens, Greece.
Melanoma Res. 2017 Aug;27(4):391-395. doi: 10.1097/CMR.0000000000000355.
Immune-related adverse effects (AEs) of PD-1 inhibitors can affect almost every organ, but the skin, intestine, lung, eye, and liver are the most commonly affected organs. Here, we present the case of a 62-year-old female patient with stage IIIc melanoma treated with nivolumab in an adjuvant setting who sequentially developed hyperthyroidism, hypothyroidism, acute hepatitis, and pneumonitis. Six months before the emergence of pneumonitis, the patient had discontinued treatment with nivolumab because of acute hepatitis. Information on pneumonitis after nivolumab discontinuation in the literature is scarce, whereas most of the cases emerge during the first 2.5 months of treatment. Patients with multiple immune-related AEs comprise a group of special interest as the identification of factors affecting the susceptibility of patients to immune-related AEs of PD-1 inhibitors may lead to a more rational use of these drugs. Human leukocyte antigen haplotype and Fcγ receptor polymorphisms are possible targets of the relevant research.
PD-1抑制剂的免疫相关不良反应（AE）几乎可累及每个器官，但皮肤、肠道、肺、眼和肝脏是最常受累的器官。在此，我们报告一例62岁IIIc期黑色素瘤女性患者，在辅助治疗中接受纳武单抗治疗，先后出现甲状腺功能亢进、甲状腺功能减退、急性肝炎和肺炎。在肺炎出现前6个月，患者因急性肝炎停用了纳武单抗。文献中关于纳武单抗停药后肺炎的信息较少，而大多数病例出现在治疗的前2.5个月。患有多种免疫相关AE的患者是一个特别值得关注的群体，因为确定影响患者对PD-1抑制剂免疫相关AE易感性的因素可能会导致这些药物的更合理使用。人类白细胞抗原单倍型和Fcγ受体多态性是相关研究的可能靶点。
