Samar Mirza Rameez, Naviwala Mohammad Saad Salim, Abdy Faryal Raza, Shahzadi Mehwish
Department of Oncology, The Aga Khan University, Karachi 74600, Pakistan.
Department of Medicine, The Aga Khan University, Karachi 74600, Pakistan.
Ecancermedicalscience. 2025 Jul 17;19:1949. doi: 10.3332/ecancer.2025.1949. eCollection 2025.
Atezolizumab is an immune checkpoint inhibitor that has been approved for several neoplasms including advanced hepatocellular carcinoma. It is also capable of inducing adverse events involving the nervous system in susceptible individuals.
We report a case of myasthenia gravis, occurring in a 64-year-old patient diagnosed with hepatocellular carcinoma, who within a few months of the first-line combination use of Atezolizumab and Bevacizumab, developed worsening muscular weakness. She was managed with plasma exchange and intravenous immunoglobulin with minimal response initially, but later on, deteriorated and succumbed to the condition.
Although uncommon, the use of Atezolizumab can either give rise to or worsen a pre-existing, latent neurological condition. These neurological immune-mediated adverse events can prove to be debilitating or even life-threatening if not timely treated, thus warranting prompt investigation by the physicians for proper diagnosis and management.
阿替利珠单抗是一种免疫检查点抑制剂，已被批准用于包括晚期肝细胞癌在内的多种肿瘤。它也能够在易感个体中诱发涉及神经系统的不良事件。
我们报告一例重症肌无力病例，发生在一名64岁被诊断为肝细胞癌的患者身上，该患者在一线联合使用阿替利珠单抗和贝伐单抗后的几个月内，出现了进行性加重的肌肉无力。她接受了血浆置换和静脉注射免疫球蛋白治疗，最初反应甚微，但后来病情恶化并最终死亡。
尽管不常见，但使用阿替利珠单抗可引发或加重先前存在的潜在神经疾病。如果不及时治疗，这些神经免疫介导的不良事件可能会使人衰弱甚至危及生命，因此需要医生及时进行调查以进行正确的诊断和管理。
