Dermatology Department, The Canberra Hospital.
Medical School, Australian National University.
Melanoma Res. 2020 Dec;30(6):599-602. doi: 10.1097/CMR.0000000000000660.
Immune checkpoint inhibitors have become the mainstay of treatment for metastatic melanoma. This article presents a new case of acquired generalised lipodystrophy (AGL) during anti-programmed cell death-1 (anti-PD-1) therapy and a systematic review of the literature with an aim to further understand the pathogenesis. A comprehensive search was conducted using PubMed, Embase, MEDLINE and Cochrane Central databases. We identified four cases of lipodystrophy associated with anti-PD-1 immunotherapy, including our own. Of these, three were associated with nivolumab, and one with pembrolizumab. Body composition changes occurred at a median of 7 months after anti-PD-1 initiation. All cases reported AGL, with subcutaneous fat loss affecting majority of the body. There were three reported cases of insulin resistance associated with AGL. AGL should be a recognised adverse event associated with anti-PD-1 therapy.
免疫检查点抑制剂已成为转移性黑色素瘤治疗的主要方法。本文介绍了一例抗程序性死亡-1（抗 PD-1）治疗期间获得性全身性脂肪营养不良（AGL）的新病例，并对文献进行了系统回顾，旨在进一步了解其发病机制。使用 PubMed、Embase、MEDLINE 和 Cochrane Central 数据库进行了全面检索。我们共确定了 4 例与抗 PD-1 免疫治疗相关的脂肪营养不良病例，包括我们自己的病例。其中，3 例与 nivolumab 相关，1 例与 pembrolizumab 相关。在抗 PD-1 起始后中位 7 个月发生了身体成分变化。所有病例均报告了 AGL，表现为皮下脂肪丢失影响了大部分身体。有 3 例报告与 AGL 相关的胰岛素抵抗。AGL 应该是与抗 PD-1 治疗相关的一种公认的不良事件。
