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[一名晚期非小细胞肺癌老年患者的帕博利珠单抗相关自身免疫性脑炎。临床病例]

[Pembrolizumab-associated autoimmune encephalitis in an elderly patient with advanced non-small cell lung cancer. A clinical case].

作者信息

Pozo Vico A, Gonzales Montejo N, Pagola Lorz I, Castillo Andueza A, Ortega Molina L Y, Alonso Renedo F J

机构信息

Servicio de Geriatría. Complejo Hospitalario de Navarra. Pamplona..

出版信息

An Sist Sanit Navar. 2021 Aug 20;44(2):291-297. doi: 10.23938/ASSN.0948.

Abstract

Therapeutic objectives for the geriatric patient are improvement of quality of life and functional capacity rather than a mere increase in survival. In neoplastic disease, the decision to initiate administration of curative therapies, especially immunotherapy, should be taken only after any potential risks have been taken into account. Geriatric patients are more susceptible to developing more serious adverse reactions than the younger population. We report the case of an octogenarian patient with non-small cell lung cancer who developed neurologic toxicity following pembroli-zumab therapy. We carry out a differential diagnosis of encephalitis and provide a literature review of pembrolizumab-associated auto-immune encephalitis cases in order to improve our knowledge of this unusual toxicity. An interdisciplinary approach and comprehensive geriatric assessment are essential components to prevent functional decline in the elderly.

摘要

老年患者的治疗目标是提高生活质量和功能能力,而非仅仅延长生存期。对于肿瘤疾病,尤其是免疫治疗等根治性疗法,只有在充分考虑所有潜在风险之后,才应决定开始使用。老年患者比年轻人群更容易发生更严重的不良反应。我们报告了一例患有非小细胞肺癌的八旬老人,在接受派姆单抗治疗后出现神经毒性的病例。我们对脑炎进行了鉴别诊断,并对派姆单抗相关的自身免疫性脑炎病例进行了文献综述,以增进我们对这种罕见毒性的了解。跨学科方法和全面的老年医学评估是预防老年人功能衰退的重要组成部分。

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