Alnabulsi Reem, Hussain Ahsen, DeAngelis Dan
a Department of Ophthalmology and Vision Sciences , University of Toronto , Toronto , Ontario , Canada.
Orbit. 2018 Oct;37(5):381-384. doi: 10.1080/01676830.2017.1423349. Epub 2018 Jan 30.
Ipilimumab and Nivolumab are novel monoclonal antibodies that have recently been used successfully for treatment of metastatic melanoma. Ipilimumab is a human monoclonal antibody against Cytotoxic T Lymphocyte Antigen 4 (CTLA4) receptor, which suppresses T-cell proliferation and stimulates an inflammatory response against cancer cells. Nivolumab is an IgG4 monoclonal antibody against the cytotoxic T lymphocyte associated programmed death 1 receptor (PD-1). Ipilimumab and Nivolumab combination treatment has been shown to induce remission and prolong survival in patients with metastatic melanoma. The side effect profile of these medications has not been well studied. One entity of the side effects reported in the literature is immune-related adverse events (irAEs). There have been few case reports where these events were serious and irreversible. In this case report, we describe a fatal and severe diffuse panmyositis that involved the cardiac, respiratory, and extraocular muscles in a patient with metastatic melanoma secondary to combination treatment with Ipilimumab/Nivolumab.
伊匹单抗和纳武单抗是新型单克隆抗体，最近已成功用于治疗转移性黑色素瘤。伊匹单抗是一种针对细胞毒性T淋巴细胞抗原4（CTLA4）受体的人源单克隆抗体，它可抑制T细胞增殖并刺激针对癌细胞的炎症反应。纳武单抗是一种针对细胞毒性T淋巴细胞相关程序性死亡1受体（PD-1）的IgG4单克隆抗体。伊匹单抗和纳武单抗联合治疗已被证明可诱导转移性黑色素瘤患者缓解并延长生存期。这些药物的副作用尚未得到充分研究。文献报道的副作用之一是免疫相关不良事件（irAEs）。很少有病例报告显示这些事件严重且不可逆。在本病例报告中，我们描述了一名转移性黑色素瘤患者在接受伊匹单抗/纳武单抗联合治疗后发生的致命且严重的弥漫性全肌炎，累及心脏、呼吸和眼外肌。
