Fang Leilei, Liu Changqin, Sun Xiaomin, Liu Zhanju
Center for IBD Research, The Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Oncol. 2022 Jun 23;12:925964. doi: 10.3389/fonc.2022.925964. eCollection 2022.
Immune checkpoint inhibitor (ICI)-induced colitis is one of the known complications of therapies targeting cytotoxic programmed cell death protein 1 (PD-1), cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), and programmed cell death ligand 1 (PD-L1). ICI-associated colitis is routinely treated with immunosuppressive therapy, including corticosteroids and/or agents targeting tumor necrosis factor-α (TNF-α). In this report, a 69-year-old male patient developed severe ICI-induced colitis 2 weeks after anti-PD-L1 mAb (i.e., durvalumab) treatment; unexpectedly failed to respond to systemic corticosteroid, anti-TNF, and anti-integrin agents; and unfortunately died in 1 month. This case reminds clinical physicians to be on the alert for early-onset acute ICI-induced colitis and emphasizes that urgent optimized rescue measures are required for patients with severe ICI-induced colitis.
免疫检查点抑制剂(ICI)诱导的结肠炎是靶向细胞毒性程序性细胞死亡蛋白1(PD-1)、细胞毒性T淋巴细胞相关抗原4(CTLA-4)和程序性细胞死亡配体1(PD-L1)治疗的已知并发症之一。ICI相关结肠炎通常采用免疫抑制治疗,包括皮质类固醇和/或靶向肿瘤坏死因子-α(TNF-α)的药物。在本报告中,一名69岁男性患者在接受抗PD-L1单克隆抗体(即度伐鲁单抗)治疗2周后发生严重的ICI诱导结肠炎;出乎意料的是,对全身皮质类固醇、抗TNF和抗整合素药物均无反应;不幸的是,患者在1个月内死亡。该病例提醒临床医生警惕早期发作的急性ICI诱导结肠炎,并强调对于严重ICI诱导结肠炎患者需要采取紧急优化的抢救措施。