Pembrolizumab-Induced Acral Vasculitis.
Journal
Journal of immunotherapy (Hagerstown, Md. : 1997)
ISSN: 1537-4513
Titre abrégé: J Immunother
Pays: United States
ID NLM: 9706083
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
received:
01
06
2022
accepted:
25
01
2023
pubmed:
23
2
2023
medline:
11
3
2023
entrez:
22
2
2023
Statut:
ppublish
Résumé
Immune checkpoint inhibitors (ICIs) have emerged as groundbreaking new therapies for a variety of solid tumors. ICIs stimulate the host immune system to attack cancer cells. However, this nonspecific immune activation can cause autoimmunity across multiple organ systems-this is referred to as an immune-related adverse event. Vasculitis secondary to ICI administration is an extremely rare event seen in <1% of cases. We identified 2 cases of pembrolizumab-induced acral vasculitis at our institution. The first patient, with stage IV adenocarcinoma of the lung, developed antinuclear antibody-positive vasculitis 4 months after initiation of treatment with pembrolizumab. The second patient had stage IV oropharyngeal cancer and presented with acral vasculitis 7 months after starting pembrolizumab. Unfortunately, both cases resulted in dry gangrene and poor outcomes. Here, we discuss the incidence, pathophysiology, clinical features, treatment, and prognosis of patients with ICI-induced vasculitis with the intention of raising awareness about this rare and potentially fatal immune-related adverse event. Early diagnosis and discontinuation of ICIs are critical for improving clinical outcomes in this situation.
Identifiants
pubmed: 36809300
doi: 10.1097/CJI.0000000000000457
pii: 00002371-202304000-00004
doi:
Substances chimiques
pembrolizumab
DPT0O3T46P
Antineoplastic Agents, Immunological
0
Antibodies, Monoclonal, Humanized
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107-110Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
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