BMC Rheumatology | |
Small vessel vasculitis and dry gangrene secondary to combined CTLA-4 and PD-1 blockade in malignant mesothelioma | |
Peter Szlosarek1  Catherine Harwood2  Joanna Kefas3  Myles J. Lewis4  | |
[1] Barts Cancer Institute, Queen Mary University of London, London, UK;Department of Dermatology, Royal London Hospital, London, UK;Department of Medicine, St Bartholomew’s Hospital, London, UK;Department of Rheumatology, Barts and the London, London, UK; | |
关键词: Mesothelioma; Immunotherapy; Immune related adverse events; Vasculitis; Case report; | |
DOI : 10.1186/s41927-021-00238-8 | |
来源: Springer | |
【 摘 要 】
BackgroundMalignant pleural mesothelioma (MPM) is a rare and aggressive tumour with an overall poor prognosis. In October 2020, first line treatment with the PD-1 antagonist nivolumab and the CTLA-4 antagonist ipilimumab for unresectable disease was FDA approved—the first approved treatment regime since 2004. Interim analyses from the phase 3 CHECKMATE-743 study shows improvements in overall survival. Skin-related toxicities are the most commonly reported any-grade treatment-related adverse event from combined nivolumab and ipilimumab therapy.Case presentationHere we report a case of a 35-year-old white male who developed digital ischaemia secondary to small vessel vasculitis after receiving PD-1 and CTLA-4 blockade therapy for MPM. His progressive ischaemia became gangrenous, and he required multi-speciality input and treatment with prednisolone, prostacyclin, mycophenolate mofetil and hydroxychloroquine.ConclusionsOur case highlights the importance of early detection, intervention, and a multispecialty approach to managing such complications in order to minimise the associated morbidity and mortality.
【 授权许可】
CC BY
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
RO202202173068153ZK.pdf | 1057KB | download |