天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (11): 1215-1217.doi: 10.11958/20170859

• 临床研究 • 上一篇    下一篇

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#br#

王薇，邢舴，曹冉华，闫海成，苏乌云   

  1. 内蒙古医科大学附属医院肿瘤内科
  • 收稿日期:2017-08-04 修回日期:2017-09-18 出版日期:2017-11-15 发布日期:2017-11-15
  • 通讯作者: 闫海成 E-mail:nmgyhc1129@163.com
  • 基金资助:
    国家自然科学基金资助项目（81660469）；内蒙古自治区自然科学基金资助项目（2015MS0831）；内蒙古自治区自然科学博士基
    金资助项目（2016BS0809）

Severe immune-related adverse events in the treatment with Pembrolizumab for a patient with ampullar carcinoma#br#

WANG Wei,XING Ze,CAO Ran-hua,YAN Hai-cheng,SU Wu-yun   

  1. Department of Medical Oncology, Affiliated Hospital of Inner Mongolia Medical University
  • Received:2017-08-04 Revised:2017-09-18 Published:2017-11-15 Online:2017-11-15

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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。

关键词: 十二指肠肿瘤, 壶腹癌, 程序性死亡受体-1, Pembrolizumab, 免疫损伤

Abstract: 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.

Key words: duodenal neoplasms, ampullar carcinoma, programmed death receptor-1, pembrolizumab, immune-related injury

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