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阿替利珠单抗诱发广泛期小细胞肺癌患者亚急性小脑共济失调。

Atezolizumab-induced subacute cerebellar ataxia in a patient with extensive-stage small cell lung cancer.

作者信息

Chen Chun-Chia, Tseng Kuan-Hua, Lai Kuan-Lin, Chiang Chi-Lu

机构信息

Department of Chest Medicine, Taipei Veterans General Hospital.

Neurological Institute, Taipei Veterans General Hospital, Taipei.

出版信息

Ther Adv Med Oncol. 2023 Aug 31;15:17588359231192398. doi: 10.1177/17588359231192398. eCollection 2023.

Abstract

Recently, immune checkpoint inhibitors (ICIs) have become the standard treatment option for patients with lung cancer, including small cell lung cancer (SCLC). ICI-induced neurological immune-related adverse events are rare and exhibit diverse clinical manifestations, often leading to missed or delayed diagnosis. Herein, we report the case of a patient with extensive-stage SCLC who received atezolizumab with etoposide/platinum and gradually developed neurological symptoms after three cycles of chemoimmunotherapy. Subsequently, the patient received a diagnosis of subacute immune-related cerebellar ataxia and was treated successfully with pulse steroid therapy. The patient exhibited almost complete remission of neurological symptoms and had progression-free survival for >24 months.

摘要

最近,免疫检查点抑制剂(ICIs)已成为肺癌患者(包括小细胞肺癌(SCLC))的标准治疗选择。ICI诱导的神经免疫相关不良事件罕见,临床表现多样,常导致漏诊或误诊。在此,我们报告一例广泛期SCLC患者,该患者接受阿替利珠单抗联合依托泊苷/铂类化疗,在三个周期的化疗免疫治疗后逐渐出现神经症状。随后,该患者被诊断为亚急性免疫相关小脑共济失调,并通过脉冲类固醇疗法成功治愈。该患者神经症状几乎完全缓解,无进展生存期>24个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f7b/10475224/47b2cad49e65/10.1177_17588359231192398-fig1.jpg

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