比利时鲁汶Ziekenhuis大学Frédéric Amant团队研究了一例子宫内暴露于派姆单抗后的严重免疫相关性肠炎患儿。相关论文发表在2023年11月8日出版的《新英格兰医学杂志》上。

免疫检查点阻断已经成为许多类型癌症的标准治疗方法。这种治疗最常用于晚期或转移性疾病的患者，但在早期疾病的患者中越来越多地被用作辅助治疗。不良事件包括类似自身免疫性疾病的免疫相关器官炎症。

研究组报道了一例4个月大婴儿的严重免疫相关胃肠炎病例，该婴儿在子宫内暴露于派姆单抗后出现顽固性腹泻和发育不良。排除症状的已知原因后，组织病理学分析、免疫表型和针对程序性细胞死亡蛋白1（PD-1）的抗体水平分析结果支持派姆单抗诱导的免疫相关胃肠炎的诊断。经泼尼松龙和英夫利昔单抗治疗，婴儿的病情得到成功缓解。

附：英文原文

Title: Severe Immune-Related Enteritis after In Utero Exposure to Pembrolizumab

Author: Manuel A. Baarslag, Joosje H. Heimovaara, Jessica S.W. Borgers, Koen J. van Aerde, Hans J.P.M. Koenen, Ruben L. Smeets, Pauline L.M. Buitelaar, Dick Pluim, Shoko Vos, Stefanie S.V. Henriet, Jan Willem B. de Groot, Martine van Grotel, Hilde Rosing, Jos H. Beijnen, Alwin D.R. Huitema, John B.A.G. Haanen, Frédéric Amant, Nicole Gierenz

Issue&Volume: 2023-11-08

Abstract:

Immune checkpoint blockade has become standard treatment for many types of cancer. Such therapy is indicated most often in patients with advanced or metastatic disease but has been increasingly used as adjuvant therapy in those with early-stage disease. Adverse events include immune-related organ inflammation resembling autoimmune diseases. We describe a case of severe immune-related gastroenterocolitis in a 4-month-old infant who presented with intractable diarrhea and failure to thrive after in utero exposure to pembrolizumab. Known causes of the symptoms were ruled out, and the diagnosis of pembrolizumab-induced immune-related gastroenterocolitis was supported by the results of histopathological assays, immunophenotyping, and analysis of the level of antibodies against programmed cell death protein 1 (PD-1). The infant’s condition was successfully treated with prednisolone and infliximab.

DOI: 10.1056/NEJMoa2308135

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2308135