内容紹介
Psoriasis and Psoriatic Arthritis Induced by Nivolumab in a Patient with Advanced Non-Small-Cell Lung Cancer
Summary
Background: Immune checkpoint-blocking antibodies may induce specific side effects known as immune-related adverse events. Case presentation: A 66-year-old man without any history of autoimmune disease was referred to our hospital for treatment of lung cancer in the right upper lobe. The tumor was diagnosed as Stage ⅢA non-small-cell lung cancer by using bronchoscopic biopsy, computed tomography, and FDG-PET. After a single course of cisplatin and pemetrexed, the tumor size increased remarkably and the regimen was changed to nivolumab(3 mg/kg every 2 weeks). Psoriasis and psoriatic arthritis were observed after 4 courses of nivolumab. Nivolumab treatment continued, and the oral administration of prednisolone(20 mg/day)could improve psoriasis and psoriatic arthritis. However, the lung cancer showed progressive disease after the 11th course of nivolumab. Conclusion: Psoriasis and psoriatic arthritis were induced by nivolumab in the patient without any history of autoimmune disease. It is unclear how prednisolone affected nivolumab for the treatment of lung cancer.
要旨
背景: 免疫チェックポイント阻害薬であるニボルマブ投与後に乾癬・乾癬性関節炎が生じた症例を報告する。症例: 66歳,男性。右肺上葉に3.7 cmの腫瘍を認めた。自己免疫疾患の既往はなかった。画像検査および生検で非小細胞肺癌,臨床病期T3N2M0,Stage ⅢAと診断した。シスプラチンとペメトレキセドを1コース施行するも腫瘍は増大し,ニボルマブに変更した。4回投与後に尋常性乾癬,乾癬性関節炎を発症し,プレドニゾロン20 mg/dayを内服投与し改善した。ニボルマブは11回目にprogressive diseaseとなるまで継続し,緩和ケア病院へ転院となった。考察: 既往がない症例においてニボルマブで乾癬・乾癬性関節炎が発症した。ステロイド投与が肺癌に対するニボルマブの効果に影響を及ぼしたかは不明であった。自己免疫疾患と肺癌治療への影響について検討が必要である。
目次
Summary
Background: Immune checkpoint-blocking antibodies may induce specific side effects known as immune-related adverse events. Case presentation: A 66-year-old man without any history of autoimmune disease was referred to our hospital for treatment of lung cancer in the right upper lobe. The tumor was diagnosed as Stage ⅢA non-small-cell lung cancer by using bronchoscopic biopsy, computed tomography, and FDG-PET. After a single course of cisplatin and pemetrexed, the tumor size increased remarkably and the regimen was changed to nivolumab(3 mg/kg every 2 weeks). Psoriasis and psoriatic arthritis were observed after 4 courses of nivolumab. Nivolumab treatment continued, and the oral administration of prednisolone(20 mg/day)could improve psoriasis and psoriatic arthritis. However, the lung cancer showed progressive disease after the 11th course of nivolumab. Conclusion: Psoriasis and psoriatic arthritis were induced by nivolumab in the patient without any history of autoimmune disease. It is unclear how prednisolone affected nivolumab for the treatment of lung cancer.
要旨
背景: 免疫チェックポイント阻害薬であるニボルマブ投与後に乾癬・乾癬性関節炎が生じた症例を報告する。症例: 66歳,男性。右肺上葉に3.7 cmの腫瘍を認めた。自己免疫疾患の既往はなかった。画像検査および生検で非小細胞肺癌,臨床病期T3N2M0,Stage ⅢAと診断した。シスプラチンとペメトレキセドを1コース施行するも腫瘍は増大し,ニボルマブに変更した。4回投与後に尋常性乾癬,乾癬性関節炎を発症し,プレドニゾロン20 mg/dayを内服投与し改善した。ニボルマブは11回目にprogressive diseaseとなるまで継続し,緩和ケア病院へ転院となった。考察: 既往がない症例においてニボルマブで乾癬・乾癬性関節炎が発症した。ステロイド投与が肺癌に対するニボルマブの効果に影響を及ぼしたかは不明であった。自己免疫疾患と肺癌治療への影響について検討が必要である。