Fukui Mototaka, Chihara Yusuke, Takahashi Yuki, Sai Natsuki, Doi Hiroshi, Nakakubo Yuto, Saito Masahiko
Pulmonology, Uji-Tokushukai Medical Center, Uji, JPN.
Pulmonology, Kyoto Prefectural University of Medicine, Kyoto, JPN.
Cureus. 2024 May 30;16(5):e61395. doi: 10.7759/cureus.61395. eCollection 2024 May.
One of the immune-related adverse events from immune checkpoint inhibitors (ICIs) is skin toxicity. Oral corticosteroids are the first-line treatment for severe cutaneous immune-related adverse events. However, corticosteroids may conflict with the efficacy of ICIs. A 55-year-old Japanese man with a history of psoriasis vulgaris was diagnosed with small-cell lung cancer (Stage ⅣA) and administered combined chemoimmunotherapy, including atezolizumab, which resulted in exacerbation of psoriasis. In response, he was treated with biological agents, such as anti-IL-23 and IL-17 antibodies, risankizumab, and secukinumab, respectively, and achieved long-term survival with continued treatment with atezolizumab. This case report suggests that biological agents might be the best course of treatment against autoimmune-related adverse events caused by ICI therapy.
免疫检查点抑制剂（ICI）引起的免疫相关不良事件之一是皮肤毒性。口服糖皮质激素是治疗严重皮肤免疫相关不良事件的一线药物。然而，糖皮质激素可能会与ICI的疗效产生冲突。一名55岁有寻常型银屑病病史的日本男性被诊断为小细胞肺癌（ⅣA期），并接受了包括阿替利珠单抗在内的联合化疗免疫治疗，这导致了银屑病的加重。作为应对措施，他分别接受了生物制剂治疗，如抗IL-23和IL-17抗体、司库奇尤单抗和瑞莎珠单抗，并在继续使用阿替利珠单抗治疗的情况下实现了长期生存。本病例报告表明，生物制剂可能是治疗ICI疗法引起的自身免疫相关不良事件的最佳治疗方案。
