医学
易普利姆玛
无容量
心肌炎
不利影响
内科学
相伴的
黑色素瘤
重症肌无力
外科
癌症
免疫疗法
癌症研究
作者
Panagiotis Diamantopoulos,Katerina Tsatsou,Οlga Benopoulou,Μaria Bonou,Amalia Anastasopoulou,Elpida Mastrogianni,Helen Gogas
出处
期刊:Melanoma Research
[Lippincott Williams & Wilkins]
日期:2020-07-21
卷期号:30 (5): 484-491
被引量:11
标识
DOI:10.1097/cmr.0000000000000681
摘要
Immune checkpoint inhibitors (ICI) have altered the prognosis of patients with melanoma over the past few years, with immune-related adverse effects (irAEs) being the only factor limiting their use. Neurologic and cardiac irAEs are rare, but usually severe. We reviewed the files of patients with melanoma treated with ICIs in one center to retrieve data from patients with neurologic irAEs. Patients with a combination of neurologic and cardiac manifestations were further analyzed. We also reviewed the literature for similar syndromes. Five out of 482 (1.01%) patients developed a neurologic syndrome and we present three patients with a constellation of neurologic and cardiac irAEs. A 66-year-old woman and a 68-year-old man presented with a constellation of findings after being treated with ipilimumab and nivolumab, respectively, for melanoma in the adjuvant setting and were eventually diagnosed with myasthenia gravis with cardiac involvement. An 80-year-old woman developed diffuse asymmetric muscle weakness, bilateral ptosis and asymptomatic high serum troponin levels after adjuvant treatment with nivolumab and ipilimumab for a stage IIIB melanoma. After excluding ischemic heart disease, she was diagnosed with axonal polyradiculoneuropathy and myocarditis. Neurologic or cardiac irAEs in patients treated with ICIs are uncommon (<1%), but usually severe, with high rates of morbidity and fatality. The co-development of neurologic and cardiac irAEs is even more rare and can arise soon after exposure to ICIs and escalate rapidly. Since more and more patients are now treated with ICIs in the adjuvant setting, prompt identification and management are essential to avoid serious complications or death.
科研通智能强力驱动
Strongly Powered by AbleSci AI