Kikuta Shogo, Abe Yushi, Shinozaki Katsumi, Seki Naoko, Kusukawa Jingo
Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, JPN.
Cureus. 2024 Jan 29;16(1):e53203. doi: 10.7759/cureus.53203. eCollection 2024 Jan.
Immune checkpoint inhibitors (ICIs) like nivolumab and pembrolizumab are effective treatments for recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). However, they can lead to immune-related adverse events (irAEs) and tuberculosis (TB) reactivation. We present a case of a 79-year-old male with recurrent maxillary squamous cell carcinoma treated with pembrolizumab, cisplatin, and 5-fluorouracil. The patient developed a fever, and pulmonary TB development was confirmed. Prolonged TB treatment was required, and ICI treatment was discontinued. The patient ultimately opted for palliative care due to aggressive tumor growth. TB development during ICI treatment is a rare but important concern, especially in TB-endemic areas. Vigilant monitoring and screening might be essential to manage this risk in cancer patients with R/M SCCHN receiving ICIs.
纳武单抗和派姆单抗等免疫检查点抑制剂是治疗复发性/转移性头颈部鳞状细胞癌（R/M SCCHN）的有效方法。然而，它们可能导致免疫相关不良事件（irAEs）和结核病（TB）复发。我们报告一例79岁男性复发性上颌鳞状细胞癌患者，接受派姆单抗、顺铂和5-氟尿嘧啶治疗。患者出现发热，确诊为肺结核。需要长期抗结核治疗，并停用免疫检查点抑制剂治疗。由于肿瘤生长迅速，患者最终选择姑息治疗。免疫检查点抑制剂治疗期间发生结核病虽然罕见但却是一个重要问题，尤其是在结核病流行地区。对于接受免疫检查点抑制剂治疗的R/M SCCHN癌症患者，警惕性监测和筛查对于管理这种风险可能至关重要。
