Myositis/myasthenia after pembrolizumab in a bladder cancer patient with an autoimmunity-associated HLA: Immune–biological evaluation and case report

Autor: Roberto Maisano, Giovanna Orizzonte, Giorgio Restifo, Pierpaolo Correale, Michele Caraglia, Vincenzo Dattola, Cirino Botta, Rita Agostino, Rita Emilena Saladino, Domenico Mazzacuva, Rocco Giannicola, Antonia Consuelo Falzea, Natale Daniele Calandruccio, Antonino Mafodda, Umberto Aguglia, Giovanna Bianco, Eleonora Iuliano, Vittoria Cianci
Přispěvatelé: Botta, C., Agostino, R. M., Dattola, V., Cianci, V., Calandruccio, N. D., Bianco, G., Mafodda, A., Maisano, R., Iuliano, E., Orizzonte, G., Mazzacuva, D., Falzea, A. C., Saladino, R. E., Giannicola, R., Restifo, G., Aguglia, U., Caraglia, M., Correale, P., Botta C., Agostino R.M., Dattola V., Cianci V., Calandruccio N.D., Bianco G., Mafodda A., Maisano R., Iuliano E., Orizzonte G., Mazzacuva D., Falzea A.C., Saladino R.E., Giannicola R., Restifo G., Aguglia U., Caraglia M., Correale P.
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Oncology
Male
Case Report
Autoimmunity
Pembrolizumab
PD1-checkpoint inhibitors
medicine.disease_cause
0302 clinical medicine
Antineoplastic Agents
Immunological

Biology (General)
HLA Antigen
Myositi
PD1-checkpoint inhibitor
Spectroscopy
Myositis
General Medicine
Computer Science Applications
Myasthenia Gravi
Chemistry
Pyridostigmine
urothelial cancer
030220 oncology & carcinogenesis
Urinary Bladder Neoplasm
Class-I/II HLA
Myasthenia
medicine.drug
Human
medicine.medical_specialty
QH301-705.5
Prognosi
Human leukocyte antigen
Antibodies
Monoclonal
Humanized

Catalysis
Inorganic Chemistry
03 medical and health sciences
Internal medicine
medicine
Physical and Theoretical Chemistry
Adverse effect
Molecular Biology
QD1-999
Aged
business.industry
Organic Chemistry
Cancer
medicine.disease
Discontinuation
030104 developmental biology
business
Zdroj: International Journal of Molecular Sciences, Vol 22, Iss 6246, p 6246 (2021)
International Journal of Molecular Sciences
Popis: 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: OpenAIRE