Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Portugal.
J Int Med Res. 2024 Nov;52(11):3000605241297551. doi: 10.1177/03000605241297551.
This case report evaluated the efficacy and safety of dupilumab, a monoclonal antibody targeting interleukin-4 and interleukin-13, in a patient with atopic dermatitis (AD) and a history of metastatic renal cancer. Over 20 months of follow-up, the patient experienced significant improvement in AD symptoms without any recurrence of cancer. In addition to not stimulating carcinogenesis, dupilumab might synergistically inhibit tumor-induced immunosuppression, thereby potentially preventing tumor progression. This case suggests that dupilumab could be a viable treatment option for patients with AD and a history of solid neoplasms, filling a critical gap in current therapeutic approaches. Current evidence indicates that dupilumab does not promote cancer progression, but further research is necessary to confirm its long-term safety in this population. To establish robust scientific evidence and develop precise clinical guidelines, future studies should be randomized, controlled, and large-scale. This will help provide a definitive understanding of the safety and efficacy of dupilumab in patients with a history of cancer and inform clinical practice. In summary, although the initial findings are promising, comprehensive research is essential to ensure the optimal management of AD in patients with a history of malignancies.
本病例报告评估了靶向白细胞介素-4 和白细胞介素-13 的单克隆抗体度普利尤单抗在患有特应性皮炎(AD)和转移性肾细胞癌病史的患者中的疗效和安全性。在 20 多个月的随访中,患者的 AD 症状显著改善,且癌症无复发。除了不刺激致癌作用外,度普利尤单抗还可能协同抑制肿瘤诱导的免疫抑制,从而潜在地防止肿瘤进展。该病例提示度普利尤单抗可能是 AD 合并实体瘤病史患者的一种可行治疗选择,填补了当前治疗方法的关键空白。目前的证据表明度普利尤单抗不会促进癌症进展,但需要进一步研究以确认其在该人群中的长期安全性。为了建立强有力的科学证据并制定精确的临床指南,未来的研究应该是随机的、对照的和大规模的。这将有助于明确了解癌症病史患者使用度普利尤单抗的安全性和疗效,并为临床实践提供信息。总之,尽管初步发现很有希望,但全面研究对于确保癌症病史患者 AD 的最佳管理至关重要。