Lie Gabrielle, Weickhardt Andrew, Kearney Leighton, Lam Que, John Thomas, Liew David, Arulananda Surein
Department of Medical Oncology, Olivia Newton-John Cancer and Wellness Centre, Heidelberg, Australia.
Cancer Immuno-Biology Laboratory, Olivia-Newton John Cancer Research Institute, Heidelberg, Australia.
Transl Lung Cancer Res. 2020 Apr;9(2):360-365. doi: 10.21037/tlcr.2020.02.05.
Malignant pleural mesothelioma (MPM) remains a deadly disease with limited therapeutic options beyond platinum/pemetrexed chemotherapy. Immune checkpoint inhibitors have demonstrated modest benefit in the second to later-line settings. An MPM patient from our institute developed myocarditis and myositis after 2 cycles of second-line nivolumab. Despite immunosuppression with corticosteroids and mycophenolate mofetil, there was ongoing rise in troponin levels which remained elevated for months. The patient developed an impressive but brief response following cessation of nivolumab. Myocarditis and myositis are rare complications of immune checkpoint inhibitors. Clinicians should be aware of these possible complications as myocarditis can result in mortality.
恶性胸膜间皮瘤（MPM）仍然是一种致命疾病，除铂类/培美曲塞化疗外，治疗选择有限。免疫检查点抑制剂在二线及后续治疗中已显示出一定益处。我们研究所的一名MPM患者在接受2个周期的二线纳武单抗治疗后发生了心肌炎和肌炎。尽管使用了皮质类固醇和霉酚酸酯进行免疫抑制，但肌钙蛋白水平仍持续上升，并持续数月居高不下。该患者在停用纳武单抗后出现了显著但短暂的反应。心肌炎和肌炎是免疫检查点抑制剂罕见的并发症。临床医生应意识到这些可能的并发症，因为心肌炎可能导致死亡。
