Pembrolizumab治疗十二指肠壶腹部癌过程中引发严重免疫相关不良反应  

Severe immune-related adverse events in the treatment with Pembrolizumab for a patient with ampullar carcinoma

作　　者：王薇[1] 邢舴[1] 曹冉华[1] 闫海成[1] 苏乌云[1] WANG Wei;XING Ze;CAO Ran-hua;YAN Hai-cheng;SU Wu-yun(Department of Medical Oncology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010051,China)

机构地区：[1]内蒙古医科大学附属医院肿瘤内科,010051

出　　处：《天津医药》2017年第11期1215-1217,共3页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(81660469);内蒙古自治区自然科学基金资助项目(2015MS0831);内蒙古自治区自然科学博士基金资助项目(2016BS0809)

摘　　要：程序性死亡受体-1(PD-1)抑制剂Pembrolizumab通过阻断PD-1与其配体PD-L1结合,阻断负向调控信号通路,恢复T细胞的功能活性,增强机体的抗肿瘤免疫应答。激活的T细胞在抗肿瘤的过程中可能导致严重的免疫相关不良反应。本文报道1例PD-1抑制剂Pembrolizumab在治疗晚期十二指肠壶腹部肉瘤样癌过程中引发的严重的免疫相关不良反应,患者最终因肝损伤、白细胞及中性粒细胞数目增加、血小板数目下降、弥漫性血管内凝血(DIC)等多系统损伤导致死亡。本文回顾了该患者的诊治经过并复习相关文献资料。Programmed death receptor-1inhibitor pembrolizumab can restore the function of T cell activity and enhance the anti-tumor immune response by inhibiting the binding of PD-1to its ligand PD-L1and blocking the negative regulation of signal pathway.The activated T cells may cause immune-mediated adverse events in the process of anti-tumor.This article reported the severe immune related adverse effects induced by PD-1inhibitor,pembrolizumab,in a patient with advanced ampullar carcinoma.The patient eventually died due to liver injury,leukocytosis,thrombocytopenia,and disseminated intravascular coagulation(DIC).This article reviewed the diagnosis and treatment of the patient,and reviewed the relevant literatures.

关 键 词：十二指肠肿瘤 壶腹癌 程序性死亡受体-1 Pembrolizumab 免疫损伤 

分 类 号：R735[医药卫生—肿瘤]