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卡瑞利珠单抗相关免疫检查点抑制剂肺炎:病例报告及文献复习。

Immune checkpoint inhibitor-related pneumonitis induced by camrelizumab: a case report and review of literature.

机构信息

Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):8460-8466. doi: 10.21037/apm-21-23. Epub 2021 May 12.

DOI:10.21037/apm-21-23
PMID:34044548
Abstract

Immune checkpoint inhibitors (ICIs) are new agents that are efficacious in a variety of cancers. However, they are associated with immune-related adverse events due to activated immune system. Among them, checkpoint inhibitor pneumonitis (CIP) deserves more special attentions, because diagnosis and therapy are still challengeable. camrelizumab is a programmed cell death 1 (PD-1) inhibitor that was developed by Jiangsu Hengrui Medicine Co. CIP that is induced by camrelizumab was rarely reported. We described a case that a patient developed CIP 12 days later after one dose of camrelizumab. A 60-year-old man with advanced esophageal squamous cell carcinoma received 6 cycles of Tislelizumab/placebo, capecitabine and cisplatin first. Owing to the poor control of the disease, the patient used Nimotuzumab and docetaxel on April 3, 2020 and April 24, 2020, respectively. Later, he obtained the combination of 200 mg of camrelizumab and 140 mg of docetaxel regimen for once on May 14, 2020. After 12 days, he was diagnosed with CIP in Outpatient. Multiple ground glass opacities were revealed in bilateral lungs from routine CT examination. After giving 40 mg of prednisolone orally once a day, his CIP improved. Meanwhile, camrelizumab was not used again. Teaching point: same as other PD-1 inhibitors, camrelizumab can also cause immune-related pneumonitis. Close observation, regular CT examination and timely corticosteroids intervention are essential.

摘要

免疫检查点抑制剂(ICIs)是一类在多种癌症中有效的新型药物。然而,由于免疫系统被激活,它们与免疫相关的不良反应有关。其中,检查点抑制剂性肺炎(CIP)需要特别注意,因为其诊断和治疗仍然具有挑战性。卡瑞利珠单抗是江苏恒瑞医药公司开发的一种程序性细胞死亡蛋白 1(PD-1)抑制剂。由卡瑞利珠单抗引起的 CIP 很少见报道。我们描述了一例患者在接受单次卡瑞利珠单抗治疗 12 天后发生 CIP 的病例。一名 60 岁男性,患有晚期食管鳞状细胞癌,首先接受了 6 个周期的替雷利珠单抗/安慰剂、卡培他滨和顺铂治疗。由于疾病控制不佳,患者分别于 2020 年 4 月 3 日和 2020 年 4 月 24 日使用尼妥珠单抗和多西他赛。后来,他于 2020 年 5 月 14 日接受了 200mg 卡瑞利珠单抗和 140mg 多西他赛的联合治疗方案,单次用药。12 天后,他在门诊被诊断为 CIP。常规 CT 检查显示双肺弥漫性磨玻璃影。给予 40mg 泼尼松龙口服,1 次/天后,他的 CIP 有所改善。同时,未再次使用卡瑞利珠单抗。教学要点:与其他 PD-1 抑制剂一样,卡瑞利珠单抗也可引起免疫相关性肺炎。密切观察、定期 CT 检查和及时使用皮质类固醇干预至关重要。

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