纳武利尤单抗相关的晚期肾细胞癌患者的数字小血管血管炎。
Nivolumab-associated digital small-vessel vasculitis in a patient with an advanced renal cell carcinoma.
机构信息
Department of Medical oncology, Puerta de Hierro University Hospital, Majadahonda, Spain.
Department of Rheumatology, Puerta de Hierro University Hospital, Majadahonda, Spain.
出版信息
Immunotherapy. 2019 Apr;11(5):379-384. doi: 10.2217/imt-2018-0082.
The immunotherapy (IO) agents in the renal cell carcinoma represent the best option in the second line of treatment. However, these drugs can be associated with different types of toxicities. The vascular toxicity related with IO is very uncommon. We report a case of a 46-year-old man diagnosed with stage IV renal cell carcinoma. He received a second-line treatment with nivolumab. After the fourth cycle, he presented a small-vessel serious vasculitis associated with IO toxicity. He required treatment with corticosteroids and immunosuppressors for toxicity control. We speculate that the anti-PD-1 agents can generate a disproportionate vascular inflammatory process mediated by T cells. The data suggest that there is an intimate relationship between alterations in the PD-1/PD-L1 pathway and vasculitis.
免疫疗法（IO）药物是肾细胞癌二线治疗的最佳选择。然而，这些药物可能会引起不同类型的毒性。与 IO 相关的血管毒性非常罕见。我们报告了一例 46 岁男性，诊断为 IV 期肾细胞癌。他接受了纳武利尤单抗二线治疗。在第四个周期后，他出现了与 IO 毒性相关的小血管严重血管炎。他需要皮质类固醇和免疫抑制剂治疗来控制毒性。我们推测抗 PD-1 药物可能会引发由 T 细胞介导的不成比例的血管炎症过程。这些数据表明 PD-1/PD-L1 通路的改变与血管炎之间存在密切关系。
Zotero 插件