PD-1/PD-L1抑制剂在非黑色素瘤治疗中致白癜风的文献病例分析  

Literature case analysis of vitiligo caused by PD-1/PD-L1 inhibitors in nonmelanoma patients

作　　者：尹岳松 吴玉佩 周晔[1] 李阳[1] 邓新娜[1] 李庆霞[1] YIN Yue-song;WU Yu-pei;ZHOU Ye;LI Yang;DENG Xin-na;LI Qing-xia(Department of Oncology,Hebei General Hospital,Shijiazhuang 050051,China;Department of Pharmacy,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院肿瘤科,河北石家庄050051 [2]河北省人民医院药学部,河北石家庄050051

出　　处：《现代药物与临床》2022年第9期2114-2121,共8页Drugs & Clinic

基　　金：河北省重点研发计划项目(20377769D);河北省医学科学研究课题计划(20220891)。

摘　　要：目的探讨程序性死亡受体1(PD-1)/程序性死亡配体1(PD-L1)抑制剂在非黑色素瘤治疗中所致白癜风的临床特点。方法检索中国知网、万方医学、PubMed、Embase、Web of Science建库至2022年7月31日收录的PD-1/PD-L1抑制剂在非黑色素瘤中所致白癜风的病例报告类文献进行描述性统计分析。结果纳入分析的患者共25例,其中男性18例,女性7例;年龄32~79岁;25例患者首次使用PD-1/PD-L1抑制剂至发生白癜风最短时间为6 d,最长时间为5年,中位发生时间为用药后5个月。白癜风主要分布在头皮、面部、手部、四肢和躯干,可伴有其他免疫相关性不良事件,以甲状腺居多;皮肤活检表现为病变及病灶周围皮肤黑色素细胞及黑色素的缺失。20名患者进行了疗效评估,完全缓解6例,部分缓解3例,疾病稳定8例,疾病进展3例。结论白癜风是PD-1/PD-L1抑制剂在非黑色素瘤治疗中的一种罕见不良反应,白癜风的发生可能与良好的临床结果相关。Objective To investigate the clinical characteristics of programmed death receptor 1(PD-1)/programmed death ligand 1(PD-L1)inhibitors induced vitiligo in the treatment of non-melanoma.Methods Case reports of vitiligo caused by PD-1/PD-L1 inhibitors in non-melanoma patients were retrieved from CNKI,Wanfang Medical,PubMed,Embase,and Web of Science until July 31,2022.Descriptive statistical analysis was performed.Results A total of 25 patients were included in the analysis,including 18 males and 7 females.The age ranged from 32 to 79 years.The shortest time from the first use of PD-1/PD-L1 inhibitor to the development of vitiligo in 25 patients was 6 days,the longest time was 5 years,and the median time was 5 months after the treatment.Vitiligo is mainly distributed in the scalp,face,hands,limbs and trunk,and can be accompanied by other immune-related adverse events,most of which are thyroid.Skin biopsy showed the absence of melanocytes and melanin in the skin surrounding the lesion.A total of 20 patients were evaluated,including 6 with complete response,3 with partial response,8 with stable disease and 3 with progressive disease.Conclusions Vitiligo is a rare adverse reaction of PD-1/PD-L1 inhibitors during non-melanoma treatment,which may be correlated with favorable clinical outcome.

关 键 词：PD-1/PD-L1抑制剂 非黑色素瘤 白癜风 不良反应 疗效评估 

分 类 号：R979.1[医药卫生—药品]