Gatti Federica, Caruso Gianluca, Potenza Concetta, Santini Daniele, Petrozza Vincenzo, Annetta Alessandro, Ceddia Serena, Cosimati Antonella, Brandi Martina, Sorrentino Veronica, Proietti Ilaria, Rossi Luigi
Department of Clinical and Molecular Medicine, 'Sapienza' University of Rome, I-00185 Rome, Italy.
Department of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, 'Sapienza' University of Rome, I-04100 Latina, Italy.
Oncol Lett. 2023 Jun 2;26(1):311. doi: 10.3892/ol.2023.13897. eCollection 2023 Jul.
Therapeutic options for non-small cell lung cancer (NSCLC) have changed with the introduction of immune checkpoint inhibitors. Immunotherapy is generally well tolerated, but can also be associated with severe adverse events, such as the development of new autoimmune diseases. In patients without a history of autoimmune diseases, psoriasis caused by immunotherapy treatment is rarely described in the literature. The present study describes the case of a 68-year-old man with metastatic NSCLC that started chemoimmunotherapy with carboplatin plus pemetrexed plus pembrolizumab. After two cycles of therapy, the patient developed a G3 maculopapular rash. Biopsy confirmed psoriasis and pembrolizumab treatment was discontinued. At the last follow up, the patient was still on maintenance therapy with pemetrexed alone, which is well tolerated. Psoriasis has rarely been reported as an immune-related adverse event. Although the patient had to stop the immunotherapy treatment, the patient is still exhibiting a response to it. Notably, it has previously been described how skin toxicities are associated with a better outcome. Other studies need to be conducted to identify the risk and predictive factors associated with severe immune adverse events and objective response.
随着免疫检查点抑制剂的引入，非小细胞肺癌（NSCLC）的治疗选择发生了变化。免疫疗法一般耐受性良好，但也可能与严重不良事件相关，如新发自身免疫性疾病。在无自身免疫性疾病病史的患者中，免疫疗法治疗引起的银屑病在文献中鲜有描述。本研究描述了一名68岁转移性NSCLC男性患者的病例，该患者开始接受卡铂加培美曲塞加帕博利珠单抗的化疗免疫治疗。两个疗程后，患者出现3级斑丘疹。活检确诊为银屑病，帕博利珠单抗治疗停药。在最后一次随访时患者仍仅接受培美曲塞维持治疗，耐受性良好。银屑病作为免疫相关不良事件鲜有报道。虽然患者不得不停止免疫治疗，但仍表现出对治疗的反应。值得注意的是，此前已有研究描述皮肤毒性与更好的预后相关。还需要开展其他研究以确定与严重免疫不良事件和客观反应相关的风险及预测因素。
