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首页> 外文期刊>Experimental Hematology Oncology >Autoimmune rhabdomyolysis and a multiorgan display of PD-1 inhibitor induced immune related adverse events during treatment of metastatic melanoma
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Autoimmune rhabdomyolysis and a multiorgan display of PD-1 inhibitor induced immune related adverse events during treatment of metastatic melanoma

机译：自身免疫性横纹肌分解和PD-1抑制剂诱导的免疫相关不良事件的多功能展示在转移性黑色素瘤中

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Programmed death-1 (PD-1) inhibitors are among the immunotherapies that have revolutionized our approach to treating several cancers. These novel agents act by blocking PD-1 receptor/PD-1 ligand interactions that would otherwise allow tumor cells to evade host immune destruction by inhibiting response of cytotoxic T-lymphocytes. They are overall well tolerated, though they have been associated with a constellation of immune mediated adverse events (irAEs). We present a case of rare nivolumab mediated adverse events in a patient with nodular recurrence of melanoma. The patient presented with rhabdomyolysis and shortly thereafter developed a constellation of immune-mediated organ derangements. This case further demonstrates the utility and effectiveness of steroid therapy in the setting of irAEs despite our patient's eventual poor clinical outcome. While PD-1 inhibitors have revolutionized the treatment of several cancers, they require vigilance by the clinician for early detection and treatment of uncommon but potentially fatal irAEs. PD-1 inhibitors are now widely used in a multitude of cancer types including melanoma, advanced non-small cell lung cancer, metastatic renal cell carcinoma, and Hodgkin lymphoma amongst others. While these agents are often well tolerated, they are associated with a unique profile of immune-related toxicities that can cause significant morbidity and mortality. Education of both patients and healthcare providers is essential for diagnosis and treatment of these adverse events early in their course. This case highlights the uncommon but potentially serious PD-1-associated toxicity of myopathy and rhabdomyolysis along with other organ involvement and is directly applicable to use of these agents in patients with advanced cancers.
机译：编程死亡-1（PD-1）抑制剂是彻底改变了治疗几种癌症的方法的免疫疗法之一。这些新型剂通过阻断PD-1受体/ Pd-1配体相互作用，否则将允许肿瘤细胞通过抑制细胞毒性T淋巴细胞的反应来逃避宿主免疫破坏。它们是整体耐受性，尽管它们与免疫介导的不良事件（IRAES）的星座相关联。我们提出了一种罕见的Nivolumab介导的黑色素瘤的患者介导的不良事件。患者患有横纹肌溶解，此后短暂地发育了一种免疫介导的器官紊乱的星座。这种情况进一​​步展示了类固醇治疗在伊拉斯的环境中的效用和有效性，尽管我们患者最终的临床结果。虽然PD-1抑制剂已经彻底改变了几种癌症的治疗，但它们需要临床医生警惕，以便早期发现和治疗罕见但可能致命的伊拉伯斯。 PD-1抑制剂现在广泛用于多种癌症类型，包括黑素瘤，晚期非小细胞肺癌，转移性肾细胞癌和霍奇金淋巴瘤等。虽然这些药剂通常耐受良好，但它们与可引起显着的发病率和死亡率的独特免疫相关毒性型材相关。患者和医疗保健提供者的教育对于课程早期对这些不良事件的诊断和治疗至关重要。这种情况突出了肌病和横纹肌分解的罕见但潜在的严重PD-1相关毒性以及其他器官受累，并直接适用于使用晚期癌症患者的这些药剂。

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