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抗程序性死亡配体-1 抗体治疗非小细胞肺癌过程中出现 Vogt-Koyanagi-Harada 病样葡萄膜炎:1 例报告

Development of Vogt-Koyanagi-Harada Disease-like Uveitis during Treatment by Anti-programmed Death Ligand-1 Antibody for Non-small Cell Lung Cancer: A Case Report.

机构信息

Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Ocul Immunol Inflamm. 2022 Aug;30(6):1522-1526. doi: 10.1080/09273948.2021.1884889. Epub 2021 Apr 2.

Abstract

BACKGROUND

Several types of immune checkpoint inhibitors (ICIs) have been reported to occasionally cause Vogt-Koyanagi-Harada disease (VKHD)-like uveitis. Among the ICIs, the anti-programmed death ligand-1 (PD-L1) antibody is reported to cause fewer immune-related adverse events (irAEs). We report a case of VKHD-like uveitis that developed after anti-PD-L1 antibody treatment for non-small cell lung cancer (NSCLC).

CASE PRESENTATION

A 76-year-old woman suffered from an acute visual reduction in both eyes. She had been treated with atezolizumab, an anti-PD-L1 antibody, for NSCLC for 17 months. Ophthalmologic examinations led to a diagnosis of severe VKHD-like uveitis, and one of the irAEs was suspected. Discontinuation of atezolizumab and systemic steroid therapy led to the resolution of the findings within two months.

CONCLUSIONS

This is the first report of VKHD-like uveitis that developed during the treatment by anti-PD-L1 antibody. Our case indicates that VKHD-like uveitis may be induced after a long-time use of anti-PD-L1 antibody.

摘要

背景

已有报道称,几种免疫检查点抑制剂(ICI)偶尔会引起 Vogt-Koyanagi-Harada 病(VKHD)样葡萄膜炎。在 ICI 中,抗程序性死亡配体 1(PD-L1)抗体引起的免疫相关不良反应(irAE)较少。我们报告了一例抗 PD-L1 抗体治疗非小细胞肺癌(NSCLC)后发生的 VKHD 样葡萄膜炎病例。

病例介绍

一名 76 岁女性因双眼急性视力下降就诊。她曾接受 atezolizumab(一种抗 PD-L1 抗体)治疗 NSCLC 17 个月。眼科检查提示为严重的 VKHD 样葡萄膜炎,疑似发生了一种 irAE。停用 atezolizumab 和全身类固醇治疗后,两个月内检查结果得到缓解。

结论

这是首例抗 PD-L1 抗体治疗期间发生 VKHD 样葡萄膜炎的报告。我们的病例表明,抗 PD-L1 抗体长期使用后可能会引发 VKHD 样葡萄膜炎。

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