Immunotherapy-Related Pancreatitis: A Case Series of 8 Patients from a High-Volume Oncology Centre.

IF 0.7 Q4 ONCOLOGY
Case Reports in Oncology Pub Date : 2025-08-19 eCollection Date: 2025-01-01 DOI:10.1159/000548016
Tomás San Martín, Jaime González-Montero, Alberto Espino, Carlos Rojas, Mauricio Burotto
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Abstract

Introduction: Immune checkpoint inhibitors (ICIs) may lead to immune-related adverse events (irAEs), including the rare complication of immune-related acute pancreatitis (irAP). Current knowledge about irAP is limited to case reports and retrospective studies.

Case presentations: We retrospectively reviewed 8 patients diagnosed with irAP at a high-volume tertiary cancer centre in Chile between 2021 and 2025. Data were collected on cancer type, immunotherapy regimen, symptoms, enzyme levels, imaging, and treatment. The irAP diagnosis was established according to the American Gastroenterological Association criteria. Adverse reactions were graded using CTCAE v5.0. Of the 8 included patients, 4 had melanoma, 2 had breast cancer, and 2 prostate cancer. Seven received PD-1/CTLA-4 combination therapy, and 1 received anti-PD-1 monotherapy. The median time to the irAP diagnosis was 5 months. Seven patients presented with gastrointestinal symptoms. Enzyme elevations and imaging findings were variable. All patients were treated with systemic corticosteroids, and 3 required hospitalisation. Four patients were rechallenged with ICIs. Other grade ≥2 irAEs were observed in 6 patients. No deaths were directly attributable to irAP.

Conclusion: As demonstrated, these manifestations can diverge substantially from those of classical pancreatitis, so establishing an irAP diagnosis requires a comprehensive assessment. Corticosteroids are an effective treatment in most cases, and ICI rechallenge may be feasible in selected patients. This case series adds 8 new reports to the limited literature on irAP, underscoring its clinical heterogeneity and the need for tailored management. Further research and detailed case reporting are essential to improve diagnosis and treatment of this rare toxicity.

免疫治疗相关性胰腺炎:来自高容量肿瘤中心的8例病例系列
免疫检查点抑制剂(ICIs)可能导致免疫相关不良事件(irAEs),包括罕见的免疫相关急性胰腺炎(irAP)并发症。目前对irAP的了解仅限于病例报告和回顾性研究。病例介绍:我们回顾性分析了2021年至2025年间在智利的一个高容量三级癌症中心诊断为irAP的8例患者。收集有关癌症类型、免疫治疗方案、症状、酶水平、影像学和治疗的数据。irAP诊断是根据美国胃肠病学协会的标准建立的。不良反应采用CTCAE v5.0分级。在纳入的8名患者中,4名患有黑色素瘤,2名患有乳腺癌,2名患有前列腺癌。PD-1/CTLA-4联合治疗7例,抗PD-1单药治疗1例。诊断为irAP的中位时间为5个月。7例患者出现胃肠道症状。酶升高和影像学表现各不相同。所有患者均接受全身皮质类固醇治疗,其中3例需要住院治疗。4例患者再次接受ICIs治疗。6例患者出现其他≥2级irae。没有直接归因于伊拉克战争的死亡。结论:如上所述,这些表现与经典胰腺炎有很大差异,因此建立irAP诊断需要全面评估。在大多数情况下,皮质类固醇是一种有效的治疗方法,在某些患者中,ICI再挑战可能是可行的。本病例系列为有限的irAP文献增加了8份新报告,强调了其临床异质性和量身定制管理的必要性。进一步的研究和详细的病例报告对于改善这种罕见毒性的诊断和治疗至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.40
自引率
12.50%
发文量
151
审稿时长
7 weeks
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