Xiong Ge, Young Richard Benjamin, Chow Helen, Maverakis Emanual, Maselli Ricardo A, Richman David Paul, Li Tianhong
Department of Neurology, School of Medicine, University of California, Davis, Sacramento, CA, United States.
Division of Hematology/Oncology, Department of Internal Medicine, School of Medicine, University of California, Davis, Sacramento, CA, United States.
Front Oncol. 2023 Jul 3;13:1199195. doi: 10.3389/fonc.2023.1199195. eCollection 2023.
Immune checkpoint inhibitors cause rare but potentially fatal neuromuscular complications, leading to a concern to use these agents in cancer patients with pre-existing autoimmune or inflammatory neuromuscular diseases. We report two such patients with paraneoplastic dermatomyositis and "seronegative" paraneoplastic demyelinating neuropathy, respectively, who have been successfully treated with immune checkpoint inhibitor monotherapy as well as maintenance intravenous immunoglobulin. While controlling the paraneoplastic or autoimmune neuromuscular diseases, the use of intravenous immunoglobulin did not compromise the anti-cancer effect of immune checkpoint inhibitor.
免疫检查点抑制剂会引发罕见但可能致命的神经肌肉并发症,这使得人们在患有自身免疫性或炎性神经肌肉疾病的癌症患者中使用这些药物时有所顾虑。我们分别报告了两名这样的患者,一名患有副肿瘤性皮肌炎,另一名患有“血清阴性”副肿瘤性脱髓鞘性神经病,他们均已成功接受免疫检查点抑制剂单一疗法以及维持性静脉注射免疫球蛋白治疗。在控制副肿瘤性或自身免疫性神经肌肉疾病的同时,静脉注射免疫球蛋白的使用并未削弱免疫检查点抑制剂的抗癌效果。