Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki, Japan.
Front Endocrinol (Lausanne). 2021 Oct 12;12:722586. doi: 10.3389/fendo.2021.722586. eCollection 2021.
Recently, immune checkpoint inhibitors have been drawing much attention as cancer immunotherapy, but it has been shown that various immune-related adverse events (irAEs) are induced by immune checkpoint inhibitors in various organs, which has become one of the serious issues at present. A 58-year-old Japanese male with malignant melanoma was treated with nivolumab and/or ipilimumab. During the period of treatment, he suffered from various irAEs. Firstly, about 1 month after starting nivolumab monotherapy, destructive thyroiditis was induced, and so we started replacement therapy with levothyroxine. Secondly, about 1 month after starting nivolumab and ipilimumab combination therapy, aseptic meningitis was induced. We stopped both drugs and started steroid therapy with prednisolone. Finally, about 9 months after restarting nivolumab, isolated adrenocorticotropic hormone (ACTH) deficiency was induced, and so we started replacement therapy with hydrocortisone. Taken together, we should bear in mind the possibility of a variety of irAEs when we use immune checkpoint inhibitors.
最近，免疫检查点抑制剂作为癌症免疫疗法受到了广泛关注，但已表明免疫检查点抑制剂会在各种器官中引起各种免疫相关不良反应（irAEs），这已成为目前的严重问题之一。一位 58 岁的日本男性患有恶性黑色素瘤，接受了纳武利尤单抗和/或伊匹单抗治疗。在治疗期间，他出现了各种免疫相关不良反应。首先，在开始纳武利尤单抗单药治疗约 1 个月后，发生了破坏性甲状腺炎，因此我们开始用左甲状腺素进行替代治疗。其次，在开始纳武利尤单抗和伊匹单抗联合治疗约 1 个月后，发生了无菌性脑膜炎。我们停止了这两种药物的治疗，并开始用泼尼松龙进行类固醇治疗。最后，在重新开始纳武利尤单抗治疗约 9 个月后，发生了孤立性促肾上腺皮质激素（ACTH）缺乏症，因此我们开始用氢化可的松进行替代治疗。综上所述，当我们使用免疫检查点抑制剂时，应牢记发生各种免疫相关不良反应的可能性。
