病例报告:一例转移性胃食管交界部鳞状细胞癌患者治疗pembrolizumab诱导的系统性毛细血管渗漏综合征(SCLS)的临床经验。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
ACS Applied Bio Materials Pub Date : 2023-09-08 eCollection Date: 2023-01-01 DOI:10.3389/pore.2023.1611330
Hua Ni, Xinjia Ding, Shikai Wu, Xuan Jin
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引用次数: 1

摘要

系统性毛细血管渗漏综合征(SCLS)是免疫检查点抑制剂(ICIs)的一种罕见而复杂的不良反应。药物诱导的SCLS的诊断是基于渗出液向间质区域的弥漫性输注和排除其他原因。ICIs诱导的SCLS的最佳治疗尚未确定,尽管适当的支持性护理和皮质类固醇通常被用作一线治疗。在我们的晚期胃食管交界处鳞状细胞癌患者中,尽管ICIs诱导的SCLS通过皮质类固醇成功控制,但该患者很快就出现了癌症进展,并死于肺部感染。根据我们的经验和其他医院报告的病例,不同阶段的SCLS可能对相同的治疗有不同的反应。因此,对ICIs诱导的SCLS进行分级可能有助于对患者进行不同治疗策略的分层。此外,皮质类固醇敏感的患者,尽管放弃了致命的SCLS,但由于皮质类固醇的应用,可能有更高的癌症进展和随后感染的风险。考虑到炎症因子应与ICIs诱导的SCLS的发展密切相关,针对驱动炎症细胞因子的靶向治疗可能提供更有效、更安全的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Case report: Clinical experience of treating pembrolizumab-induced systemic capillary leak syndrome (SCLS) in one patient with metastatic gastroesophageal junction squamous cell carcinoma.

Case report: Clinical experience of treating pembrolizumab-induced systemic capillary leak syndrome (SCLS) in one patient with metastatic gastroesophageal junction squamous cell carcinoma.

Systemic capillary leak syndrome (SCLS) is a rare and complex adverse effect of immune checkpoint inhibitors (ICIs). The diagnosis of drug-induced SCLS is based on diffuse infusions of exudative fluid into the interstitial areas and the exclusion of other causes. The best management of ICIs-induced SCLS is not settled, though proper supportive care and corticosteroids were commonly applied as the first-line treatment. In our patient with advanced gastroesophageal junction squamous cell carcinoma, although ICIs-induced SCLS was successfully controlled with corticosteroids, the patient soon experienced cancer progress and died of pulmonary infections. Based on our experience and the reported cases by other hospitals, different stages of SCLS might respond differently to the same treatment. Therefore, a grading of ICIs-induced SCLS might help to stratify the patient for different treatment strategies. Besides, corticosteroids-sensitive patients, though waived from deadly SCLS, might be at higher risk of cancer progress and subsequent infections due to the application of corticosteroids. Considering that the inflammatory factors should be closely involved in the development of ICIs-induced SCLS, targeted therapy against the driver inflammatory cytokine might offer treatment regimens that are more effective and safer.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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