Taki Takahiro, Oda Naohiro, Fujioka Yusuke, Mitani Reo, Tokura Takehiko, Takata Ichiro, Oshiro Yoshiyuki, Takigawa Nagio
Department of Internal Medicine, Fukuyama City Hospital, Japan.
General Internal Medicine 3, Kawasaki Medical School, Japan.
Intern Med. 2020 Jul 1;59(13):1639-1642. doi: 10.2169/internalmedicine.4260-19. Epub 2020 Apr 9.
We herein report a 75-year-old man with non-small-cell lung cancer who developed tubulointerstitial nephritis due to pembrolizumab administration. He was successfully treated with atezolizumab following steroid administration. He was initially diagnosed with lung adenocarcinoma (T1bN3M1b, stage IV), with a programmed cell death-ligand 1 tumor proportion score of 25-49%. Although the tumor responded well to pembrolizumab, the drug was discontinued because of the diagnosis of tubulointerstitial nephritis on a renal biopsy. Tubulointerstitial nephritis was treated with 30 mg prednisolone, the dose of which was tapered to and maintained at 5 mg. Following lung cancer progression, atezolizumab was administered, and the tumor responded again. Its efficacy has been sustained for >15 months without recurrence of tubulointerstitial nephritis.
我们在此报告一名75岁的非小细胞肺癌男性患者，其因使用帕博利珠单抗而发生了肾小管间质性肾炎。在给予类固醇治疗后，他接受阿特珠单抗治疗并取得成功。他最初被诊断为肺腺癌（T1bN3M1b，IV期），程序性细胞死亡配体1肿瘤比例分数为25%-49%。尽管肿瘤对帕博利珠单抗反应良好，但由于肾活检诊断为肾小管间质性肾炎，该药物被停用。肾小管间质性肾炎采用30mg泼尼松龙治疗，剂量逐渐减至并维持在5mg。在肺癌进展后，给予阿特珠单抗，肿瘤再次出现反应。其疗效已持续超过15个月，且肾小管间质性肾炎未复发。
