Carrera William, Baartman Brandon J, Kosmorsky Gregory
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Neuroophthalmology. 2017 Mar 15;41(3):140-143. doi: 10.1080/01658107.2017.1291686. eCollection 2017 Jun.
Recently developed anti-tumour therapies targeting immune checkpoints include tremelimumab and durvalumab. These agents have incompletely characterised side effect profiles. The authors report a 68-year-old man treated for non-small cell lung cancer (NSCLC) with a combination of tremelimumab and durvalumab. After treatment he developed diplopia, ptosis, fatigue, weakness, and an inflammatory myopathy affecting the extraocular muscles requiring hospitalisation. Electromyography (EMG) testing and muscle biopsy suggested inflammatory myopathy without sign of myasthenia. Within 1 month of withdrawal of cancer therapies and initiation of oral steroid therapy, ocular and systemic symptoms had resolved. This notable adverse effect has not been previously described for these drugs administered singly or in combination, and ophthalmologists should be aware of this presentation in patients treated with these agents.
最近开发的针对免疫检查点的抗肿瘤疗法包括曲美木单抗和度伐鲁单抗。这些药物的副作用特征尚未完全明确。作者报告了一名68岁的男性，他接受了曲美木单抗和度伐鲁单抗联合治疗非小细胞肺癌（NSCLC）。治疗后，他出现了复视、上睑下垂、疲劳、无力以及影响眼外肌的炎性肌病，需要住院治疗。肌电图（EMG）检查和肌肉活检提示为炎性肌病，无重症肌无力迹象。在停止癌症治疗并开始口服类固醇治疗后的1个月内，眼部和全身症状均已缓解。这种显著的不良反应此前尚未在单独或联合使用这些药物时被描述过，眼科医生应注意接受这些药物治疗的患者出现的这种表现。
