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一名接受免疫检查点抑制剂治疗肺癌的男性出现严重细胞因子释放综合征和免疫效应细胞相关神经毒性综合征。

Severe Cytokine Release Syndrome and Immune Effector Cell-associated Neurotoxicity Syndrome in a Man Receiving Immune Checkpoint Inhibitors for Lung Cancer.

机构信息

Department of Respiratory Medicine, Okayama University Hospital, Japan.

Center for Clinical Oncology, Okayama University Hospital, Japan.

出版信息

Intern Med. 2024 May 1;63(9):1261-1267. doi: 10.2169/internalmedicine.2429-23. Epub 2023 Sep 15.


DOI:10.2169/internalmedicine.2429-23
PMID:37722894
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11116002/
Abstract

A 55-year-old man with stage IV lung adenocarcinoma was treated with cisplatin, pemetrexed, nivolumab, and ipilimumab. Approximately 100 days after treatment initiation, he became disoriented and presented to the emergency department with a high fever. Blood tests revealed liver and kidney dysfunctions. Subsequently, the patient developed generalized convulsions that required intensive care. He was clinically diagnosed with cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Organ damage was gradually controlled with immunosuppressive drugs, including steroids, and the patient was discharged. Successful treatment is rare in patients with CRS, including ICANS, during immune checkpoint inhibitor treatment for solid tumors.

摘要

一位 55 岁的 IV 期肺腺癌男性患者接受了顺铂、培美曲塞、纳武利尤单抗和伊匹单抗治疗。治疗开始后约 100 天,他出现了定向障碍,并因高热到急诊就诊。血液检查显示肝肾功能异常。随后,患者出现全身抽搐,需要重症监护。临床诊断为细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS)。通过免疫抑制剂治疗(包括类固醇)逐渐控制器官损伤,患者出院。在免疫检查点抑制剂治疗实体瘤期间,出现 CRS 包括 ICANS 的患者,其 CRS 治疗成功率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/d56438fbe651/1349-7235-63-1261-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/5186b60bc5a0/1349-7235-63-1261-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/e85db6fe81f2/1349-7235-63-1261-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/344c995f6cf4/1349-7235-63-1261-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/d56438fbe651/1349-7235-63-1261-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/5186b60bc5a0/1349-7235-63-1261-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/e85db6fe81f2/1349-7235-63-1261-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/344c995f6cf4/1349-7235-63-1261-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51f1/11116002/d56438fbe651/1349-7235-63-1261-g004.jpg

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[1]
Severe Cytokine Release Syndrome and Immune Effector Cell-associated Neurotoxicity Syndrome in a Man Receiving Immune Checkpoint Inhibitors for Lung Cancer.

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引用本文的文献

[1]
Cytokine release syndrome and immune effector cell‑associated neurotoxicity syndrome in a melanoma patient treated with adjuvant pembrolizumab.

Exp Ther Med. 2024-9-11

[2]
Cytokine release syndrome following COVID-19 infection during treatment with nivolumab for cancer of esophagogastric junction carcinoma: a case report and review.

Int J Emerg Med. 2024-9-2

[3]
Glofitamab-Associated Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) Presenting as Serial Seizures and Responding Positively to Antiseizure Drugs and Anakinra: A Case Report.

Cureus. 2024-5-22

[4]
Fever of unknown origin associated with immune checkpoint inhibitors.

Front Immunol. 2024

本文引用的文献

[1]
Immune Checkpoint Inhibitor Associated Autoimmune Encephalitis, Rare and Novel Topic of Neuroimmunology: A Case Report and Review of the Literature.

Brain Sci. 2022-6-13

[2]
Imaging Primer on Chimeric Antigen Receptor T-Cell Therapy for Radiologists.

Radiographics. 2022

[3]
Management of Immune-Related Adverse Events in Patients Treated With Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline.

J Clin Oncol. 2021-12-10

[4]
Cytokine Release Syndrome Induced by Immune-checkpoint Inhibitor Therapy for Non-small-cell Lung Cancer.

Intern Med. 2021-11-1

[5]
How to manage patients with corticosteroids in oncology in the era of immunotherapy?

Eur J Cancer. 2020-12

[6]
Immune effector cell-associated neurotoxicity syndrome after chimeric antigen receptor T-cell therapy for lymphoma: predictive biomarkers and clinical outcomes.

Neuro Oncol. 2021-1-30

[7]
Immune Checkpoint Inhibitor-Related Cytokine Release Syndrome: Analysis of WHO Global Pharmacovigilance Database.

Front Pharmacol. 2020-5-4

[8]
A case report of fulminant cytokine release syndrome complicated by dermatomyositis after the combination therapy with immune checkpoint inhibitors.

Medicine (Baltimore). 2020-4

[9]
Managing the toxicities of CAR T-cell therapy.

Hematol Oncol. 2019-6

[10]
Recent advances in CAR T-cell toxicity: Mechanisms, manifestations and management.

Blood Rev. 2018-11-14

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