Ogawa Rei, Suzuki Kunihito, Saito Katsumasa, Shinohara Hajime, Atsuta Yuya, Miura Akinori
Dept. of Esophageal Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital.
Gan To Kagaku Ryoho. 2023 Dec;50(13):1786-1788.
Immune checkpoint inhibitor(ICI)combination therapy is the first-line of treatment for unresectable or recurrent esophageal cancer. The frequency and mechanism of immune-related adverse events(irAEs)associated with ICI are still unclear and may require differentiation from other diseases. The present study examined a patient with unresectable, advanced esophageal cancer treated with cisplatin plus 5-fluorouracil(CF)plus nivolumab as the first-line treatment. CF therapy was discontinued after 1 course owing to adverse events. Nivolumab was continued, but progressive anemia stemming from pure red cell aplasia(PRCA), an irAE of nivolumab administration, was observed. Nivolumab was discontinued, but later, interstitial pneumonia also developed, and pulse steroid therapy was begun. After steroid tapering, both the PRCA and interstitial pneumonia improved. At present, about 6 months have elapsed since the last nivolumab administration without any PRCA recurrence or evidence of tumor progression.
免疫检查点抑制剂（ICI）联合疗法是不可切除或复发性食管癌的一线治疗方法。与ICI相关的免疫相关不良事件（irAE）的发生频率和机制仍不清楚，可能需要与其他疾病相鉴别。本研究检查了一名不可切除的晚期食管癌患者，该患者接受顺铂加5-氟尿嘧啶（CF）加纳武单抗作为一线治疗。由于不良事件，CF治疗在1个疗程后停药。继续使用纳武单抗，但观察到因纳武单抗给药的irAE——纯红细胞再生障碍性贫血（PRCA）导致的进行性贫血。停用纳武单抗，但后来又出现了间质性肺炎，并开始了脉冲类固醇治疗。类固醇减量后，PRCA和间质性肺炎均有所改善。目前，自上次使用纳武单抗以来已过去约6个月，没有任何PRCA复发或肿瘤进展的迹象。
