Myositis/Myasthenia after Pembrolizumab in a Bladder Cancer Patient with an Autoimmunity-Associated HLA: Immune-Biological Evaluation and Case Report.

Autor: Botta C; Unit of Hematology, Azienda Ospedaliera 'Annunziata', 87100 Cosenza, Italy.; Hematology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90128 Palermo, Italy., Agostino RM; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Dattola V; Unit of Neurology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Cianci V; Unit of Neurology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Calandruccio ND; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Bianco G; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Mafodda A; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Maisano R; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Iuliano E; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Orizzonte G; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Mazzacuva D; Laboratory of Autoimmunity, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Falzea AC; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Saladino RE; HLA Tissue Typing Laboratory, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Giannicola R; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Restifo G; Nuclear Medicine Unit, Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Aguglia U; Unit of Neurology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Caraglia M; Department of Precision Medicine, University of Campania 'L. Vanvitelli', 80138 Naples, Italy.; Laboratory of Precision and Molecular Oncology, Biogem Scarl, Institute of Genetic Research, 83031 Ariano Irpino, Italy., Correale P; Unit of Oncology, Unit. Grand Metropolitan Hospital 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy.
Jazyk: angličtina
Zdroj: International journal of molecular sciences [Int J Mol Sci] 2021 Jun 10; Vol. 22 (12). Date of Electronic Publication: 2021 Jun 10.
DOI: 10.3390/ijms22126246
Abstrakt: Pembrolizumab (mAb to PD-1) has been recently approved for the therapy of pretreated urothelial cancer. Despite the efficacy, it is often accompanied by unpredictable and sometime severe immune-related (ir) adverse events (AEs). Here, we report the clinical and immune-biological characterization of a patient with a metastatic bladder cancer who developed myositis signs (M) and a myasthenia-like syndrome (MLS) during treatment with pembrolizumab. The patient presented an autoimmunity-associated HLA haplotype (HLA-A*02/HLA-B*08/HLA-C*07/HLA-DRB1*03) and experienced an increase in activated CD8 T-cells along the treatment. The symptomatology regressed after pembrolizumab discontinuation and a pyridostigmine and steroids-based therapy. This is the first report of concurrent M and MLS appearance in cancer patients receiving pembrolizumab. More efforts are needed to define early the risk and the clinical meaning of irAEs in this setting.
Databáze: MEDLINE
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