アブストラクト
Japanese
| Title | 免疫チェックポイント阻害薬により出現した皮疹の検討 |
|---|---|
| Subtitle | 原著 |
| Authors | 大橋洋之1, 宮垣朝光1, 門野岳史1, 伊澤直樹2 |
| Authors (kana) | おおはしひろゆき, みやがきともみつ, かどのたかふみ, いざわなおき |
| Organization | 1聖マリアンナ医科大学 皮膚科学, 2聖マリアンナ医科大学 臨床腫瘍学 |
| Journal | 聖マリアンナ医科大学雑誌 |
| Volume | 49 |
| Number | 3 |
| Page | 75-82 |
| Year/Month | 2021 / |
| Article | 原著 |
| Publisher | 聖マリアンナ医科大学医学会 |
| Abstract | 「抄録」2014年7月〜2020年11月までの期間に, 当院でimmune checkpoint inhibitor(ICI)を投与した282例に対し後方視的検討を行った. Immune related Adverse Events(irAE)として皮疹を生じたものは38例, 43病変であった. 発症は女性にやや高い傾向にあった. 皮疹の出現率は悪性黒色腫が51.6%, 腎細胞癌が21.1%, 悪性胸膜中皮腫が20.0%と高かった. レジメン別では抗PD-1抗体では総投与例の12.8%, 抗PD-1抗体 + 抗CTLA-4抗体併用療法では50.0%, 抗PD-L1抗体では10.0%の症例で皮疹が出現した. 皮疹の内訳は紅斑丘疹21病変, 白斑11病変, 扁平苔癬3病変, 乾癬3病変, 皮疹3病変, 水疱性類天疱瘡1病変, 脱毛症1病変であった. 乾癬, 紅斑丘疹は早期から出現し, 白斑, 扁平苔癬は遅れて出現する傾向にあった. 皮疹のCTCAEは93.0%がGrade1〜2であったが, Grade3も7.0%に認め, 5病変でICIの投与中止が必要であった. irAEとして皮疹を生じた38例中, ICI治療奏効例は11例であったが, 内7例は悪性黒色腫であり, 特に皮疹が出現した群が有意に奏効と関連していた. 皮膚のirAEは頻度が高く, 早期から出現し, 多くは軽症であるが, 時に重症化し注意が必要である. irAEについては未だ不明な点も多く, 今後も症例の集積と科を跨いだ連携が必要である. |
| Practice | 医学総合 |
| Keywords | 免疫チェックポイント阻害薬, immune-related adverse events, 皮膚障害 |
English
| Title | Analysis of Eruptions Caused by Immune Checkpoint Inhibitors |
|---|---|
| Subtitle | |
| Authors | Hiroyuki Ohashi1, Tomomitsu Miyagaki1, Takafumi Kadono1, Naoki Izawa2 |
| Authors (kana) | |
| Organization | 1Department of Dermatology, St. Marianna University School of Medicine, 2Department of Clinical Oncology, St. Marianna University School of Medicine |
| Journal | The St. Marianna Medical Journal |
| Volume | 49 |
| Number | 3 |
| Page | 75-82 |
| Year/Month | 2021 / |
| Article | Original article |
| Publisher | St.Marianna University Society of Medical Science |
| Abstract | [Abstract] A retrospective study was performed in 282 patients who underwent treatment with immune checkpoint inhibitors (ICI) at St. Marianna University Hospital from July 2014 to November 2020. There were 38 patients with 43 lesions that revealed cutaneous immune-related adverse events (irAEs), which were observed more frequently in female patients. The incidence rate of cutaneous irAEs was the highest in malignant melanoma (51.6%) followed by renal cell carcinoma (21.1%), and malignant pleural mesothelioma (20.0%). Cutaneous irAEs occurred in 12.8% of the patients treated with anti-PD-1 antibody, 50.0% of those treated with a combination of anti-PD-1 and anti-CTLA-4 antibodies, and 10.0% of those treated with anti-PD-L1 antibody. As for the types of rashes, maculopapular rash was observed in 21 patients, vitiligo in 11 patients, lichen planus in 3 patients, psoriasis in 3 patients, eruption in 3 patients, bullous pemphigoid in 1 patient, and alopecia in 1 patient. Psoriasis and maculopapular rash appeared early; however, vitiligo and lichen planus appeared later. The Common Terminology Criteria for Adverse Events grade of eruption was 1 - 2 in 93.0% of the patients, while 7.0% of the patients reported Grade 3. The use of ICI was discontinued in 5 patients. Among the 38 patients, 5 patients had a complete response, 6 had a partial response against the tumor. Seven of these 11 responders were malignant melanoma patients. Regarding malignant melanoma cases, the response rate against melanoma was higher in patients with cutaneous irAEs than those without. Cutaneous irAEs often appear earlier than other irAEs. Most cutaneous irAEs are mild; however, we need to be cautious as severe cases exist. As several points regarding cutaneous irAEs remain unanswered, it is necessary to evaluate more cases and treat those patients in cooperation with other departments. |
| Practice | General medicine |
| Keywords | immune-related adverse events |
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残りの10件を表示する
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