Pembrolizumab治疗十二指肠壶腹部癌过程中引发严重免疫相关不良反应

摘要

程序性死亡受体-1(PD-1)抑制剂Pembrolizumab通过阻断PD-1与其配体PD-L1结合,阻断负向调控信号通路,恢复T细胞的功能活性,增强机体的抗肿瘤免疫应答.激活的T细胞在抗肿瘤的过程中可能导致严重的免疫相关不良反应.本文报道1例PD-1抑制剂Pembrolizumab在治疗晚期十二指肠壶腹部肉瘤样癌过程中引发的严重的免疫相关不良反应,患者最终因肝损伤、白细胞及中性粒细胞数目增加、血小板数目下降、弥漫性血管内凝血(DIC)等多系统损伤导致死亡.本文回顾了该患者的诊治经过并复习相关文献资料.%Programmed death receptor-1 inhibitor pembrolizumab can restore the function of T cell activity and enhance the anti-tumor immune response by inhibiting the binding of PD-1 to its ligand PD-L1 and blocking the negative regulation of signal pathway. The activated T cells may cause immune-mediated adverse events in the process of anti-tumor. This article reported the severe immune related adverse effects induced by PD-1 inhibitor, pembrolizumab, in a patient with advanced ampullar carcinoma. The patient eventually died due to liver injury, leukocytosis,thrombocytopenia,and disseminated intravascular coagulation (DIC). This article reviewed the diagnosis and treatment of the patient, and reviewed the relevant literatures.