PD-1 inhibitor therapy causes multisystem immune adverse reactions: a case report and literature review

Immune checkpoint inhibitors(ICIs), including cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4), programmed cell death protein 1 and its ligand (PD-1/PD-L1) inhibitors, have been shown to have antitumor activity in various solid tumors. Their mechanism of action is to selectively restore and normalize...

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Bibliographic Details
Published in:Frontiers in oncology 2022-09, Vol.12
Main Authors: Yin, Na, Liu, Xiangliang, Ye, Xiaojun, Song, Wei, Lu, Jin, Chen, Xiao
Format: Article
Language:English
Subjects:
immune checkpoint inhibitor
immunotherapy
lung cancer
myocarditis
myositis
Oncology
thrombocytopenia
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Summary:Immune checkpoint inhibitors(ICIs), including cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4), programmed cell death protein 1 and its ligand (PD-1/PD-L1) inhibitors, have been shown to have antitumor activity in various solid tumors. Their mechanism of action is to selectively restore and normalize the body’s immune reponses by disrupting the immunosuppressive signals mediated by PD-1, PD-L1 and CTLA-4 in the tumor microenvironment. With the increase in clinical applications of ICIs, reports of immune-related adverse events (irAEs) have also increased. This article reports a case of a lung cancer patient who developed multisystemic adverse effects after PD-1 inhibitor application: myocarditis, myositis and thrombocytopenia, and analyzes the role of Interleukin 6(IL-6)in the management of irAEs. Despite the patient’s eventual discontinuation of antitumor therapy due to severe irAEs, a significant and durable therapeutic response was observed.
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2022.961266