PD-1-inhibitor-induced PCA-2 (MAP1B) Autoimmunity in a Patient with Renal Cell Carcinoma
Autor: | Michal Ariela Raz, Avi Gadoth, Yahel Segal, Orna Aizenstein, Yifat Alcalay, Felix Bukstein |
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Rok vydání: | 2021 |
Předmět: |
T cell
Programmed Cell Death 1 Receptor Autoimmunity medicine.disease_cause 050105 experimental psychology 03 medical and health sciences 0302 clinical medicine Immune system Antigen Renal cell carcinoma medicine Humans 0501 psychology and cognitive sciences Carcinoma Renal Cell Immune Checkpoint Inhibitors Autoantibodies biology business.industry 05 social sciences Paraneoplastic cerebellar degeneration medicine.disease Kidney Neoplasms medicine.anatomical_structure Neurology Cancer research biology.protein Neurology (clinical) Nivolumab Antibody business Microtubule-Associated Proteins 030217 neurology & neurosurgery |
Zdroj: | The Cerebellum. 21:328-331 |
ISSN: | 1473-4230 |
Popis: | Immune check point inhibitors (ICIs) are a group of anti-cancer pharmacological agents which modify T cell activity in order to potentiate an effective immune response against tumor cells. While these drugs prove extremely potent against several types of malignancies, they may be associated with significant autoimmune adverse events. We report a patient who developed a subacute cerebellar syndrome shortly after starting treatment with nivolumab, a PD-1 inhibitor, for renal clear cell carcinoma, with detectable paraneoplastic PCA-2 antibodies. The tumor specimen stained positively for MAP1B, the antigen of PCA-2. The patient responded well to treatment with glucocorticosteroids. This is the first case to our knowledge of PCA-2 paraneoplastic cerebellar degeneration associated with ICI use, which presents in a patient with a malignancy not typically associated with neurological paraneoplastic phenomena. Treatment with immune checkpoint inhibitors (ICIs) is extremely effective in potentiating an immune response against tumor cells, but bears a substantial risk for the development of autoimmune phenomena, including paraneoplastic neurological syndromes. Increasing use of ICIs is leading to increasing numbers of patients with new-onset neurological symptoms. Awareness of these novel entities will aid in early diagnosis and proper treatment. |
Databáze: | OpenAIRE |
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