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非小细胞肺癌中免疫治疗相关心脏毒性的再发——一例报告

Immunotherapy-Related Cardiotoxicity Re-Emergence in Non-Small Cell Lung Cancer - A Case Report.

作者信息

Li Yuanxiang, Hu Yang, Yang Bin, Jin Caibao, Ren Hui, Wu Jingyi, Wang Zhijun, Wei Youying, Yang Ling, Hu Yanping

机构信息

Department of Oncology, Hubei Cancer Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, 430079, Hubei, People's Republic of China.

出版信息

Onco Targets Ther. 2021 Nov 23;14:5309-5314. doi: 10.2147/OTT.S333242. eCollection 2021.

Abstract

PD-1/PD-L1 inhibitors activate immunological response and have become one of the main modalities of cancer treatment. However, they may result in the immune-related adverse events (irAEs). Immune-related cardiotoxicity is relatively rare but may become fatal. We will present a case of a male patient who experienced immunotherapy-related cardiotoxicity one year after received pembrolizumab treatment. The patient had atypical symptom presentation initially, but his condition deteriorated worsened rapidly and he developed severe cardiac disease. The patient experienced significant relief after corticosteroid treatment. Unfortunately, he experienced a reoccurence of the severe adverse event when discontinuing the use of corticosteroids. Ultimately, larger doses and longer courses of corticosteroid treatment cured the heart damage. Fortunately, we observed that lesions were stable and maintained for a long time after cessation of using pembrolizumab for eight months.

摘要

PD-1/PD-L1抑制剂可激活免疫反应,已成为癌症治疗的主要方式之一。然而,它们可能会导致免疫相关不良事件(irAEs)。免疫相关心脏毒性相对罕见,但可能致命。我们将介绍一例男性患者,他在接受派姆单抗治疗一年后出现免疫治疗相关心脏毒性。患者最初症状不典型,但病情迅速恶化,发展为严重心脏病。患者在接受皮质类固醇治疗后症状明显缓解。不幸的是,停用皮质类固醇后,严重不良事件再次出现。最终,更大剂量、更长疗程的皮质类固醇治疗治愈了心脏损伤。幸运的是,在停用派姆单抗八个月后,我们观察到病变稳定并长期维持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81c3/8627268/3bea4be237f6/OTT-14-5309-g0001.jpg

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