Hu Jiarui, Fan Jieting, Qu Shaobo, He Xiaohua, Liu Daiwei, Wang Yongxia, Wu Xiaoyuan, Li Zhanlin
Department of Traditional Chinese Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China.
J Chemother. 2025 Jul;37(4):376-382. doi: 10.1080/1120009X.2024.2372525. Epub 2024 Jun 27.
Camrelizumab is an immune checkpoint inhibitor clinically used to treat various types of tumours. In this study, the authors provided the first report of a case of an anaphylactic reaction induced by camrelizumab in the treatment of a patient with squamous cell carcinoma of the floor of the mouth. The patient, a 58-year-old man, was diagnosed with advanced squamous cell carcinoma of the floor of the mouth, with cancer infiltration and multiple metastases. He underwent treatment for nine cycles, in which cycles 1-5 he received camrelizumab, albumin-bound paclitaxel, and cisplatin (200 mg of camrelizumab each time, every 3 weeks), with no adverse reactions; in cycle 6, he received albumin-bound paclitaxel and cisplatin, with no adverse reactions; and in cycles 7-9, he received camrelizumab and albumin-bound paclitaxel. However, 30 min after 8th administration of camrelizumab (cycle 9), he suddenly developed sweating, a pale complexion, clamminess and cyanosis of the limbs (percutaneous arterial oxygen saturation [SpO] = 82%, blood pressure [BP] = 79/49 mmHg, heart rate [HR] = 83 beats/min [bpm] and respiratory rate [RR) = 12 bpm). The patient underwent intravenous infusion of methylprednisolone (80 mg) combined with dopamine to boost the BP; he regained consciousness 20 min later, and many parts of his skin appeared smooth, with no desquamation and accompanied by itching erythema, especially on the upper limbs. Approximately 2 h after treatment, the patient's skin erythema subsided (vital sign monitoring results: SpO = 100%, BP = 122/84 mmHg, HR = 91 bpm and RR = 17 bpm); the patient did not complain about his obvious discomfort. Despite the rarity of acute anaphylactic reactions among immune-related adverse reactions, great importance should be given to anaphylactic reactions of camrelizumab due to its extensive clinical application.
卡瑞利珠单抗是一种临床上用于治疗多种类型肿瘤的免疫检查点抑制剂。在本研究中，作者首次报道了1例卡瑞利珠单抗治疗口腔底鳞状细胞癌患者时诱发过敏反应的病例。该患者为一名58岁男性，被诊断为晚期口腔底鳞状细胞癌，伴有癌浸润和多处转移。他接受了9个周期的治疗，其中第1 - 5周期接受卡瑞利珠单抗、白蛋白结合型紫杉醇和顺铂（每次200mg卡瑞利珠单抗，每3周一次），未出现不良反应；第6周期接受白蛋白结合型紫杉醇和顺铂，未出现不良反应；第7 - 9周期接受卡瑞利珠单抗和白蛋白结合型紫杉醇。然而，在第9周期第8次给予卡瑞利珠单抗30分钟后，他突然出现出汗、面色苍白、四肢湿冷和发绀（经皮动脉血氧饱和度[SpO₂]=82%，血压[BP]=79/49mmHg，心率[HR]=83次/分钟[bpm]，呼吸频率[RR]=12次/分钟）。患者接受了静脉输注甲泼尼龙（80mg）联合多巴胺以提升血压；20分钟后他恢复意识，其皮肤多处出现光滑、无脱屑且伴有瘙痒性红斑，尤其是上肢。治疗后约2小时，患者皮肤红斑消退（生命体征监测结果：SpO₂=100%，BP=122/84mmHg，HR=91bpm，RR=17bpm）；患者未诉说明显不适。尽管免疫相关不良反应中急性过敏反应罕见，但鉴于卡瑞利珠单抗的广泛临床应用，应高度重视其过敏反应。
