International journal of molecular sciences · 2021
Myositis/Myasthenia after Pembrolizumab in a Bladder Cancer Patient with an Autoimmunity-Associated HLA: Immune-Biological Evaluation and Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Botta Cirino, Agostino Rita Maria, Dattola Vincenzo, Cianci Vittoria, Calandruccio Natale Daniele, Bianco Giovanna, Mafodda Antonino, Maisano Roberto, Iuliano Eleonora, Orizzonte Giovanna, Mazzacuva Domenico, Falzea Antonia Consuelo, Saladino Rita Emilena, Giannicola Rocco, Restifo Giorgio, Aguglia Umberto, Caraglia Michele, Correale Pierpaolo
Аннотация
Pembrolizumab (mAb to PD-1) has been recently approved for the therapy of pretreated urothelial cancer. Despite the efficacy, it is often accompanied by unpredictable and sometime severe immune-related (ir) adverse events (AEs). Here, we report the clinical and immune-biological characterization of a patient with a metastatic bladder cancer who developed myositis signs (M) and a myasthenia-like syndrome (MLS) during treatment with pembrolizumab. The patient presented an autoimmunity-associated HLA haplotype (HLA-A*02/HLA-B*08/HLA-C*07/HLA-DRB1*03) and experienced an increase in activated CD8 T-cells along the treatment. The symptomatology regressed after pembrolizumab discontinuation and a pyridostigmine and steroids-based therapy. This is the first report of concurrent M and MLS appearance in cancer patients receiving pembrolizumab. More efforts are needed to define early the risk and the clinical meaning of irAEs in this setting.