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额外免疫抑制药物治疗皮质类固醇难治性免疫检查点抑制剂诱导的心肌炎的有效性:两例报告

Effectiveness of Additional Immunosuppressive Drugs for Corticosteroid-refractory Immune Checkpoint Inhibitor-induced Myocarditis: Two Case Reports.

作者信息

Sakaguchi Hiroyuki, Nanjo Shigeki, Sato Shigeki, Kotani Hiroshi, Nishiyama Akihiro, Yamashita Kaname, Ohtsubo Koushiro, Suzuki Chiaki, Shimojima Masaya, Yano Seiji, Takeuchi Shinji

机构信息

Department of Medical Oncology, Kanazawa University Hospital, Japan.

Department of Respiratory Medicine, Kanazawa University Hospital, Japan.

出版信息

Intern Med. 2025 Apr 15;64(8):1205-1210. doi: 10.2169/internalmedicine.4162-24. Epub 2024 Sep 4.

Abstract

Immune checkpoint inhibitors (ICIs) improve the outcomes of several types of cancer. However, they are also associated with various immune-related adverse events including myocarditis. ICI-induced myocarditis is a rare, potentially life-threatening adverse event. We herein report two cases of corticosteroid-refractory ICI-induced myocarditis. In both cases, additional immunosuppressive therapies, such as intravenous immunoglobulin and tacrolimus, successfully resolved myocarditis. Given the corticosteroid-refractory nature of these cases, we suggest that prompt addition of other immunosuppressive drugs to corticosteroid therapy should be considered in the treatment of ICI-induced myocarditis.

摘要

免疫检查点抑制剂(ICIs)改善了几种类型癌症的治疗结果。然而,它们也与包括心肌炎在内的各种免疫相关不良事件有关。ICI诱导的心肌炎是一种罕见的、潜在危及生命的不良事件。我们在此报告两例对皮质类固醇难治的ICI诱导的心肌炎病例。在这两例病例中,额外的免疫抑制治疗,如静脉注射免疫球蛋白和他克莫司,成功地解决了心肌炎问题。鉴于这些病例对皮质类固醇难治的性质,我们建议在治疗ICI诱导的心肌炎时,应考虑在皮质类固醇治疗中及时添加其他免疫抑制药物。

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