A case of bronchial asthma as an immune-related adverse event of pembrolizumab treatment for bladder cancer
| Autor: | Hamada, Kazuyuki, Yoshimura, Kiyoshi, Oshinomi, Kazuhiko, Hirasawa, Yuya, Ariizumi, Hirotsugu, Ohkuma, Ryotaro, Shida, Midori, Kubota, Yutaro, Matsui, Hiroto, Ishiguro, Tomoyuki, Sambe, Takehiko, Ishida, Hiroo, Horiike, Atsushi, Wada, Satoshi, Iwamoto, Sanju, Uchida, Naoki, Ogawa, Yoshio, Kobayashi, Shinichi, Tsunoda, Takuya |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
CD4-Positive T-Lymphocytes
anti-PD-1 antibody Programmed Cell Death 1 Receptor asthma Antibodies Monoclonal Humanized Memory T Cells Urinary Bladder Neoplasms bladder cancer immune-related adverse events Humans CTLA-4 Antigen Female Clinical Case Report pembrolizumab Hepatitis A Virus Cellular Receptor 2 Immune Checkpoint Inhibitors Research Article Aged |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Rationale: Bladder cancer is one of the most common cancers worldwide. The anti-programmed cell death protein 1 (PD-1) antibody pembrolizumab, which is an immune checkpoint inhibitor (ICI), has improved survival in bladder cancer. We report a case of bladder cancer that had a high antitumor effect with anti-programmed cell death PD-1 antibody pembrolizumab, an ICI, but asthma occurred an immune-related adverse event (irAE). Patient concerns: A 70-year-old female patient was diagnosed as unresectable bladder cancer who was indicated for ICI treatment. Diagnosis: After ICI administration as a treatment for bladder cancer, the patient had a grade 3 asthma attack. Cytotoxic T lymphocyte antigen 4 (CTLA-4) in CD4+ FOX3+ T cells was upregulated in the early phase before the development of asthma attacks. Moreover, T-cell immunoglobulin and mucin domain 3 (TIM-3) was upregulated in all memory T cells among CD4+ T cells. However, no change in the expression of TIM-3 was observed in any CD8+ T-cell subtype. In contrast, the proportion of CD161- T helper 17 cell (Th17) cells increased. Interventions: The patient was treated with betamethasone, montelukast, salbutamol nebulization, and a combination of salmeterol (50 μg) and fluticasone (500 μg) (SFC). Outcomes: The patient's wheezing resolved, and her peak flow rate reached 100% of the predicted value; therefore, the patient continued treatment with SFC and montelukast and was discharged from the hospital. Conclusion: Increases in CTLA-4 and TIM-3 expression in CD4+ T cells (not CD8+), as well as an increase in Th17 cells, may reflect asthma-related inflammation activity. Immune-related adverse events during immune checkpoint inhibitor administration may be predictive markers of antitumor efficacy. |
| Databáze: | OpenAIRE |
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