Monsour Elio P, Pothen Joshua, Balaraman Rama
Internal Medicine, University of Central Florida / Ocala Regional Medical Center, Ocala, USA.
Internal Medicine, General Medical Education, Ocala Regional Medical Center, Ocala, USA.
Cureus. 2019 Oct 2;11(10):e5824. doi: 10.7759/cureus.5824.
While immune checkpoint inhibitors have been groundbreaking for cancer treatment, there are many reported cases of patients undergoing immunotherapy who have discontinued or temporarily interrupted treatment due to the development of autoimmune-related adverse effects. Here, we present a 63-year-old female with a history of psoriasis (in spontaneous remission) and newly diagnosed poorly differentiated lung adenocarcinoma (pTXN3M1a) who experienced a severe flare-up of her psoriasis three months after initiating single-agent pembrolizumab. The patient was initially treated with topical clobetasol propionate ointment, however, due to minimal response to this regimen, the patient was commenced on secukinumab; an IL-17 inhibitor. To our knowledge, this is the first case of the successful use of secukinumab for the treatment of immunotherapy-induced psoriasis. More importantly, immunotherapy with pembrolizumab was continued successfully with the co-administration of secukinumab without complications or the recurrence of non-small cell lung cancer (NSCLC).
虽然免疫检查点抑制剂在癌症治疗方面具有开创性意义，但有许多报道称，接受免疫治疗的患者因出现自身免疫相关不良反应而停止或暂时中断治疗。在此，我们报告一例63岁女性，有银屑病病史（处于自发缓解期），新诊断为低分化肺腺癌（pTXN3M1a），在开始使用单药派姆单抗三个月后，银屑病严重复发。患者最初接受丙酸氯倍他索软膏局部治疗，然而，由于该治疗方案效果甚微，患者开始使用司库奇尤单抗；一种白细胞介素-17抑制剂。据我们所知，这是首例成功使用司库奇尤单抗治疗免疫治疗诱导的银屑病的病例。更重要的是，在联合使用司库奇尤单抗的情况下，派姆单抗免疫治疗得以成功继续，且未出现并发症或非小细胞肺癌（NSCLC）复发。
