久期的PD-1抑制剂(camrelizumab)免疫治疗后罕见的复发性胸腔积液病例报告。
Recurrent pleural effusion as a rare manifestation after prolonged PD1 inhibitor (camrelizumab)-based immunotherapy: A case report.
发表日期：2023 Aug 01
作者：
Xiao-Hong Xie, Pan-Xiao Shen, Jian-Hui Wu, Gui-Huan Qiu, Xin-Qing Lin, Zhan-Hong Xie, Yin-Yin Qin, Bin Zheng, Ming Liu, Cheng-Zhi Zhou
来源：
Cell Death & Disease
摘要：
免疫相关的不良事件（irAEs）对免疫肿瘤治疗的广泛应用提出了重要挑战，但其症状可以各异。特别是对于晚期非小细胞肺癌（NSCLC）患者的irAEs和胸腔积液（PE）之间的关系仍不清楚。在本报告中，我们展示了一例晚期NSCLC患者，在作为一线治疗接受卡瑞利珠单抗（一种抗 programmed death receptor 1 [PD-1] 的抗体）和化疗后，出现持续性PE的病例。尽管患者的肿瘤生物标志物在多个治疗周期后有所下降，但PE尽管细胞学和胸腔活检结果均为阴性，仍然持续存在。此外，使用抗血管生成药物未能缓解PE。类风湿结缔组织标志物和结核检查均为阴性，但两次胸腔内地塞米松注射导致PE显著减少。该病例表明PE可能代表一种罕见的irAE类型，在长期免疫肿瘤治疗期间应进行监测。
Immune-related adverse events (irAEs) pose a significant challenge for the widespread adoption of immuno-oncology therapies, but their symptoms can vary widely. In particular, the relationship between irAEs and pleural effusion (PE) in patients with advanced non-small cell lung cancer (NSCLC) remains unclear. In this report, we present the case of an advanced NSCLC patient who developed persistent PE despite receiving camrelizumab (an anti-programmed death receptor 1 [PD-1] antibody) and chemotherapy as first-line treatment. While the patient's tumor biomarkers decreased after multiple cycles of treatment, the PE persisted despite negative findings on cytology and pleural biopsy. Additionally, the use of anti-angiogenic drugs failed to alleviate the PE. Screening for rheumatic connective tissue markers and tuberculosis yielded negative results, but intrathoracic dexamethasone injections in two doses resulted in a significant reduction of the PE. This case suggests that PE may represent a rare type of irAE that should be monitored for during prolonged immuno-oncology therapy.