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免疫检查点抑制剂治疗非小细胞肺癌期间合并 COVID-19 感染导致细胞因子释放综合征 1 例报告。

A case of cytokine release syndrome accompanied with COVID-19 infection during treatment with immune checkpoint inhibitors for non-small cell lung cancer.

机构信息

Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.

出版信息

Thorac Cancer. 2022 Oct;13(20):2911-2914. doi: 10.1111/1759-7714.14632. Epub 2022 Sep 8.

Abstract

Cytokine release syndrome (CRS) is a systemic inflammatory disease caused by a variety of factors, including infections and certain drugs. A 70-year-old man who was diagnosed with a postoperative recurrence of lung adenocarcinoma received nivolumab, ipilimumab, pemetrexed and carboplatin every 3 weeks for two cycles followed by nivolumab and ipilimumab, which resulted in a partial response. Four days after the dose of nivolumab, the patient returned with diarrhea and fever. The patient was diagnosed with COVID-19 infection accompanied by severe colitis. Although intensive care was performed, the patient suddenly went into cardiopulmonary arrest. Examination revealed an abnormally high interleukin-6 level, suggesting CRS. This is the first report of a patient with CRS accompanied with COVID-19 infection during treatment with ICIs. Cytokine release syndrome (CRS) is a systemic inflammatory disease caused by a variety of factors, including infections and certain drugs. Here, we report a case of non-small cell lung cancer with CRS caused by COVID-19 infection during treatment with nivolumab and ipilimumab. Fever is a common event in cancer patients, especially in COVID-19-infected patients, but when fever develops during cancer immunotherapy, CRS should always be kept in mind.

摘要

细胞因子释放综合征(CRS)是一种由多种因素引起的全身性炎症性疾病,包括感染和某些药物。一位 70 岁男性,被诊断为肺癌术后复发,接受了每 3 周一次的纳武利尤单抗、伊匹单抗、培美曲塞和卡铂治疗 2 个周期,随后接受纳武利尤单抗和伊匹单抗治疗,结果显示部分缓解。纳武利尤单抗剂量给药后 4 天,患者出现腹泻和发热。该患者被诊断为 COVID-19 感染伴严重结肠炎。尽管进行了重症监护,但患者突然出现心肺骤停。检查发现白细胞介素-6 水平异常升高,提示 CRS。这是首例在接受免疫检查点抑制剂(ICIs)治疗期间并发 COVID-19 感染的 CRS 患者报告。细胞因子释放综合征(CRS)是一种由多种因素引起的全身性炎症性疾病,包括感染和某些药物。在这里,我们报告了一例非小细胞肺癌患者在接受纳武利尤单抗和伊匹单抗治疗期间因 COVID-19 感染而发生 CRS 的病例。发热是癌症患者的常见事件,尤其是 COVID-19 感染患者,但当癌症免疫治疗期间出现发热时,应始终牢记 CRS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d74/9575125/f351b6128e86/TCA-13-2911-g002.jpg

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