Yamada Takahiro, Masuda Takeshi, Yamaguchi Kakuhiro, Sakamoto Shinjiro, Horimasu Yasushi, Miyamoto Shintaro, Nakashima Taku, Iwamoto Hiroshi, Hirata Shintaro, Fujitaka Kazunori, Hamada Hironobu, Sugiyama Eiji, Hattori Noboru
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan.
Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Japan.
Intern Med. 2019 Nov 1;58(21):3129-3132. doi: 10.2169/internalmedicine.3018-19. Epub 2019 Jul 10.
The safety and efficacy of anti-programmed cell death-1 (PD-1) antibodies in patients with granulomatosis with polyangiitis (GPA) still remain unclear. An 83-year-old man with GPA that was well controlled with immunosuppressive therapy was diagnosed with a postoperative recurrence of non-small cell lung cancer (NSCLC). Because the programmed cell death ligand 1 (PD-L1) tumor proportion score was 90%, pembrolizumab was administered. After 10 cycles, immune-related adverse events or GPA flare was not observed, and the patient showed an antitumor response. Anti-PD-1 antibody should therefore be considered a treatment option for PD-L1-high-expressing NSCLC patients with well-controlled GPA.
抗程序性细胞死亡蛋白1（PD-1）抗体在肉芽肿性多血管炎（GPA）患者中的安全性和有效性仍不明确。一名83岁的男性GPA患者，通过免疫抑制治疗病情得到良好控制，被诊断为非小细胞肺癌（NSCLC）术后复发。由于程序性细胞死亡配体1（PD-L1）肿瘤比例评分达90%，给予帕博利珠单抗治疗。10个周期后，未观察到免疫相关不良事件或GPA病情复发，且患者显示出抗肿瘤反应。因此，抗PD-1抗体应被视为GPA病情得到良好控制的PD-L1高表达NSCLC患者的一种治疗选择。
