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免疫治疗因延迟和严重免疫相关不良事件停药后的持久反应:一例报告

Durable response after immunotherapy discontinuation for delayed and severe immune-related adverse events: a case report.

作者信息

Pesola Guido, Murianni Veronica, Rebuzzi Sara Elena, Banna Giuseppe Luigi, Cerbone Luigi, Catalano Fabio, Borea Roberto, Gandini Annalice, Cremante Malvina, Puglisi Silvia, Trovato Francesco, Fornarini Giuseppe

机构信息

Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.

Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, 16132, Italy.

出版信息

Immunotherapy. 2021 Dec;13(17):1379-1386. doi: 10.2217/imt-2021-0085. Epub 2021 Nov 8.

Abstract

Recent studies have shown that immune-related adverse events (irAEs), occurring even after the discontinuation of immune checkpoint inhibitors (ICIs), may be associated with favorable disease outcomes, particularly in patients with melanoma and lung cancer. However, a few clinical cases have been described on the correlation between irAEs and ICIs efficacy in renal cell carcinoma (RCC) patients. This study reports the clinical case of a metastatic RCC patient who has experienced severe immune-related renal toxicity after 19 months of nivolumab use. Despite immunotherapy discontinuation, the patient has maintained clinical benefit and disease progression-free for 3 years. We examined the correlation between the occurrence and the severity of irAEs, treatment discontinuation and clinical benefits. The evidence on ICI retreatment following ICI discontinuation due to irAEs was also reviewed.

摘要

近期研究表明,即使在停用免疫检查点抑制剂(ICI)后发生的免疫相关不良事件(irAE),也可能与良好的疾病预后相关,尤其是在黑色素瘤和肺癌患者中。然而,关于irAE与肾细胞癌(RCC)患者ICI疗效之间的相关性,仅有少数临床病例报道。本研究报告了1例转移性RCC患者的临床病例,该患者在使用纳武利尤单抗19个月后出现了严重的免疫相关肾毒性。尽管停止了免疫治疗,但该患者仍保持了3年的临床获益且无疾病进展。我们研究了irAE的发生与严重程度、治疗中断和临床获益之间的相关性。同时也回顾了因irAE而停用ICI后再次使用ICI治疗的相关证据。

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