Ito Ryota, Tatsuoka Hiroki, Hirata Tamaki, Kimura Sachiko, Sakamoto Youichi, Kashiwagi Takao, Hori Junko, Miyata Keikichi, Kishi Minoru, Iwai Masahide
Dept. of Internal Medicine, Nishiwaki Municipal Hospital.
Gan To Kagaku Ryoho. 2021 Oct;48(10):1265-1267.
The patient was a 69-year-old man diagnosed with stage ⅣB lung adenocarcinoma with 95% programmed death- ligand 1 expression, and pembrolizumab monotherapy was initiated. The patient exhibited fatigue from the 12th course(36 weeks after treatment initiation) of treatment. Chest computed tomography revealed scattered ground-glass opacities in the upper lobes of both lungs, and he was subsequently diagnosed with interstitial pneumonia. Fatigue persisted even after a drug holiday from pembrolizumab, and the patient was diagnosed with hypopituitarism based on the results of endocrinological examinations. Rashes appeared on both legs 40 weeks after treatment initiation, which led to the patient being diagnosed with a drug-induced skin disorder. All the adverse events resolved upon treatment with hydrocortisone. Immune- related adverse events due to pembrolizumab may occur in multiple organs simultaneously.
该患者为一名69岁男性,被诊断为ⅣB期肺腺癌,程序性死亡配体1表达率为95%,遂开始使用帕博利珠单抗单药治疗。患者在第12个疗程(治疗开始后36周)出现疲劳。胸部计算机断层扫描显示双肺上叶散在磨玻璃影,随后被诊断为间质性肺炎。即使在停用帕博利珠单抗进行药物假期后,疲劳仍持续存在,根据内分泌检查结果,该患者被诊断为垂体功能减退。治疗开始后40周,双腿出现皮疹,该患者被诊断为药物性皮肤疾病。所有不良事件经氢化可的松治疗后均得到缓解。帕博利珠单抗引起的免疫相关不良事件可能同时发生在多个器官。