卡多尼利单抗是第一个获批的双重免疫检查点抑制剂，靶向程序性细胞死亡蛋白1（PD-1）和细胞毒性T淋巴细胞相关蛋白4（CTLA-4），目前用于治疗各种实体瘤。口腔粘膜不良反应，例如口腔苔藓样病变，是与免疫检查点抗体相关的最常见的免疫相关不良事件之一。然而，缺乏详细说明与卡多尼利单抗相关的口服副作用的报告。记录这些副作用对于提醒肿瘤科医生和口腔科医生至关重要，以便及时对受影响的患者进行干预。我们介绍了一个病例，涉及一名被诊断患有肝细胞癌的 35 岁男性患者，他在肝切除术后接受了卡多利单抗治疗，随后出现了广泛的口腔苔藓样病变，并伴有治疗开始后 13-14 周出现粘膜糜烂。活检显示浸润口腔苔藓样病变组织的 CD3、CD4、CD8、CD20  淋巴细胞、CD68  巨噬细胞和 α-SMA  肌成纤维细胞的免疫组织化学结果。在接受全身和局部糖皮质激素治疗并停止卡多尼利单抗治疗后，患者的口腔病变得到改善。该报告标志着第一个有记录的与卡多尼利单抗使用相关的口腔不良反应实例。它强调指出，使用这种药物可能会导致口腔内出现严重的苔藓样病变和糜烂，这一问题值得肿瘤学家和口腔科医生提高警惕。© 2024。作者。

Cadonilimab is the first approved dual immune checkpoint inhibitor targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), currently utilized for the treatment of various solid tumors. Oral mucosal adverse reactions, such as oral lichenoid lesions, represent one of the most prevalent immune-related adverse events associated with immune checkpoint antibodies. However, reports detailing oral side effects specifically linked to Cadonilimab are lacking. Documenting these side effects is essential to alert oncologists and stomatologists, facilitating timely intervention for affected patients.We present a case involving a 35-year-old male patient diagnosed with hepatocellular carcinoma who received Cadonilimab following hepatectomy and subsequently developed extensive oral lichenoid lesions along with mucosal erosion at 13-14 weeks post-treatment initiation. A biopsy was conducted revealing immunohistochemical findings of CD3+, CD4+, CD8+, CD20 + lymphocytes, CD68 + macrophages, and α-SMA + myofibroblasts infiltrating the tissue of the oral lichenoid lesions. The patient's oral lesions improved after administration of systemic and local glucocorticoid therapy alongside cessation of Cadonilimab treatment.This report marks the first documented instance of an oral adverse effect associated with Cadonilimab use. It underscores that administration of this agent may lead to significant lichenoid lesions and erosions within the oral cavity-an issue warranting increased vigilance from both oncologists and stomatologists.© 2024. The Author(s).