Teixeira Carina, Costa Rúben, Silva Miguel, Ribeiro Maria João, Sousa Isabel
Oncology, Unidade Local de Saúde de São João, Porto, PRT.
Dermatology, Unidade Local de Saúde de São João, Porto, PRT.
Cureus. 2025 Feb 7;17(2):e78698. doi: 10.7759/cureus.78698. eCollection 2025 Feb.
Patients with end-stage renal disease are a challenge for oncologists. Despite the recognised benefit in the overall survival of pembrolizumab in patients with advanced melanoma, data on its safety and efficacy in dialysis patients are scarce. We present a clinical case of an 87-year-old woman on haemodialysis with advanced melanoma treated in the first line with pembrolizumab 200 mg every three weeks. She shows no significant adverse events and a good response to treatment. Although she underwent surgical treatment for two oligoprogressions, the patient maintained treatment with pembrolizumab, now demonstrating a response duration of 20 months. The age and comorbidities in this case, coupled with the lack of robust scientific evidence on the use of immunotherapy in dialysis patients, illustrate the daily complexity of therapeutic decisions in oncology.
终末期肾病患者对肿瘤学家来说是一项挑战。尽管帕博利珠单抗对晚期黑色素瘤患者的总生存期有公认的益处，但关于其在透析患者中的安全性和有效性的数据却很稀少。我们报告了一例87岁接受血液透析的晚期黑色素瘤女性患者的临床病例，该患者一线接受每三周200毫克帕博利珠单抗治疗。她未出现明显不良事件，且对治疗反应良好。尽管她因两次寡进展接受了手术治疗，但患者仍继续接受帕博利珠单抗治疗，目前显示缓解持续时间为20个月。该病例中的年龄和合并症，再加上缺乏关于免疫疗法在透析患者中应用的有力科学证据，说明了肿瘤学治疗决策日常面临的复杂性。
