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免疫检查点抑制剂在患有预先存在的肉状瘤病的癌症患者中的应用。

Use of immune checkpoint inhibitors in cancer patients with pre-existing sarcoidosis.

机构信息

Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

Immunotherapy. 2021 Apr;13(6):465-475. doi: 10.2217/imt-2020-0272. Epub 2021 Mar 1.

Abstract

To evaluate adverse events in cancer patients with pre-existing sarcoidosis receiving immune checkpoint inhibitors (ICIs). We retrospectively reviewed cancer patients with sarcoidosis who underwent treatment with ICI to determine frequency of sarcoidosis flares. 32 patients with sarcoidosis received ICIs The median time to ICI initiation was 7 years (range: 1 month to 51 years). One patient (3%) with a 20-year remote history of sarcoidosis developed a clinically symptomatic exacerbation after three doses of atezolizumab, with hilar lymphadenopathy, subcutaneous nodules, arthritis and uveitis. Atezolizumab was discontinued and prednisone initiated. She had a fluctuating course with two additional flares. Frequency of flares in patients with a remote history of sarcoidosis who receive ICIs is low.

摘要

评估患有预先存在的结节病的癌症患者在接受免疫检查点抑制剂 (ICI) 治疗时的不良事件。我们回顾性地分析了接受 ICI 治疗的结节病癌症患者,以确定结节病发作的频率。32 例结节病患者接受了 ICI 治疗,ICI 起始时间的中位数为 7 年(范围:1 个月至 51 年)。1 例(3%)有 20 年结节病史的患者在接受阿替利珠单抗 3 剂后出现临床症状恶化,表现为肺门淋巴结肿大、皮下结节、关节炎和葡萄膜炎。停用阿替利珠单抗并开始使用泼尼松龙。她的病情波动,有两次额外的发作。有结节病病史的患者在接受 ICI 治疗时,发作的频率较低。

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