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항Hu 및 항SOX1자가항체가 동시에 확인된 아테졸리주맙 연관 자가면역뇌염
은미연,하형석,황재춘 대한신경과학회 2024 대한신경과학회지 Vol.42 No.1
Although immune checkpoint inhibitor-related encephalitis has been reported, its underlying mechanism and treatment strategies remain unclear. Here, we present the case of a 60-yearold male patient with small cell lung cancer who developed autoimmune encephalitis during treatment with atezolizumab. Notably, this case involved the concurrent detection of two paraneoplastic autoantibodies (anti-Hu and anti-SOX1). Encephalitis was treated by discontinuing atezolizumab and administering steroids, despite the persistence of the antibodies. This case provides insights into the interaction between immune checkpoint inhibitors and paraneoplastic autoantibodies.
Cutaneous adverse events of anti-PD-1 and anti-PD-L1 therapy
( Dokyoung Yoon ),( Hyun Jeong Byun ),( Chan Seong Park ),( Youngkyoung Lim ),( Jong Hee Lee ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ),( Ji-hye Park ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2
Background: Anti-PD-1 and anti-PDL-1 therapy have been growing widely used as an effective treatment for various types of cancer by enhancing pre-existing immune responses to tumor cell. Objectives: We reviewed cutaneous adverse events (AEs) caused by anti-PD-1 and anti-PDL-1 therapy for facilitating dermatologists to immediate diagnosis and proper management. Methods: A retrospective study was conducted on patients referred to dermatology for skin lesion after treated with pembrolizumab, nivolumab, or atezolizumab from January 1st, 2015 to June 30th, 2018. Results: Of 1286 patients screened for the study, 33 patients (2.57%) were referred to dermatology with cutaneous AEs. 16 out of 675 patients (2.37%) showed cutaneous AEs after pembrolizumab therapy, 14 out of 562 patients (2.49%) did the same after nivolumab, and 3 out of 72 patients (4.17%) did the same after atezolizumab. 648 patients (50.43%) were treated for lung cancer, followed by 132 patients (10.27%) for melanoma. Of 33 patients with cutaneous AEs, 11 patients (33.33%) were with melanoma, followed by 10 patients (30.30%) were with lung cancer. In 12 types of cutaneous AEs observed, pruritic eruption (10 patients, 28.57%) was the most common cutaneous AE. The average onset was 21.79 weeks. Erythema multiforme, the earliest, took 7 weeks and nail change, the latest, took 52.33 weeks. Conclusion: Anti PD-1 and PDL-1 therapy can cause various cutaneous AEs that dermatologists are supposed to be aware of.
허준영,김유진,권기영,강민용,성현환,전황균,정병창,서성일,전성수,이현무,이수진,박세훈 대한암학회 2019 Cancer Research and Treatment Vol.51 No.4
Purpose Treatment targeting immune checkpoint with programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors has demonstrated efficacy and tolerability in the treatment of metastatic urothelial carcinoma (mUC). We investigated the efficacy and safety of atezolizumab in mUC patients who failed platinum-based chemotherapy. Materials and Methods A retrospective study using the Samsung Medical Center cancer chemotherapy registry was performed on 50 consecutive patients with mUC treated with atezolizumab, regardless of their PD-L1 (SP142) status, as salvage therapy after chemotherapy failure between May 2017 and June 2018. Endpoints included overall response rate (RR), progression-free survival (PFS), and safety. Results Among 50 patients, men constituted 76% and the median age was 68 years (range, 46 to 82 years). Twenty-three patients (46%) received atezolizumab as second-line therapy. PD-L1 (SP142) status IC0/1 and IC2/3 were found in 21 (42%) and 21 (42%) of patients, respectively; in eight patients (16%), PD-L1 (SP142) expression was not available. Atezolizumab was generally well tolerated, with pruritus and fatigue being the most commonly observed toxicities. As a result, partial response was noted in 20 patients (40%), with 12 (24%) stable diseases. RR was higher in IC2/3 (62%) than in IC0/1 patients (24%, p=0.013). The median PFS was 7.4 months (95% confidence interval, 3.4 to 11.4 months). As expected, PFS also was significantly longer in IC2/3 patients than in IC0/1 (median, 12.7 vs. 2.1 months; p=0.005). PFS was not significantly influenced by age, sex, performance status, number of previous chemotherapy, site of metastases, or any of the baseline laboratory parameters. Conclusion In this retrospective study, atezolizumab demonstrated clinically efficacy and tolerability in unselected mUC patients who failed platinum-based chemotherapy.
최명근,김연주,이재철,지원준,오인재,이승룡,윤성훈,이신엽,이정은,김은영,최창민 대한암학회 2024 Cancer Research and Treatment Vol.56 No.2
Purpose The addition of immune checkpoint inhibitors to chemotherapy has improved survival outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC). However, their real-world effectiveness remains unknown. Therefore, we investigated the effectiveness of atezolizumab plus chemotherapy in ES-SCLC in actual clinical settings. Materials and Methods In this multicenter prospective cohort study, patients with ES-SCLC receiving or scheduled to receive atezolizumab in combination with etoposide and carboplatin were enrolled between June 2021 and August 2022. The primary outcomes were progression-free survival (PFS) and the 1-year overall survival (OS) rate. Results A total of 100 patients with ES-SCLC were enrolled from seven centers. Median age was 69 years, and 6% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2. The median PFS was 6.0 months, the 1-year OS rate was 62.2%, and the median OS was 13.5 months. An ECOG PS of 2-3 and progressive disease as the best response were poor prognostic factors for PFS, while an ECOG PS of 2-3 and brain metastasis were associated with poor prognosis for OS. In addition, consolidative thoracic radiotherapy was found to be an independent favorable prognostic factor for OS (hazard ratio, 0.336; p=0.021). Grade ≥ 3 treatment-related adverse events were observed in 7% of patients, with treatment-related deaths occurring in 2% of patients. Conclusion We provided evidence of the favorable real-world effectiveness and safety of atezolizumab plus chemotherapy in ES-SCLC patients, including in the elderly and those with poor ECOG PS. Additional consolidative thoracic radiotherapy may also benefit ES-SCLC patients.
김태현,김보현,조유리,고영환,박중원 대한간암학회 2023 대한간암학회지 Vol.23 No.2
Background/Aim: Radiotherapy (RT) is an effective local treatment for hepatocellular carcinoma (HCC). However, whether additional RT is safe and effective in patients with advanced HCC receiving atezolizumab plus bevacizumab remains unclear. This retrospective cohort study aimed to evaluate the feasibility of additional RT in these patients. Methods: Between March and October 2021, we retrospectively analyzed seven patients with advanced HCC who received RT during treatment with atezolizumab plus bevacizumab. The median prescribed RT dose was 35 Gy (range, 33–66). Freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) after RT were analyzed. Results: The median follow-up duration after RT was 14.2 months (range, 10.0–18.6). Of the seven patients, disease progression was noted in six (85.7%), the sites of disease progression were local in two (28.6%), intrahepatic in four (57.1%), and extrahepatic in four (57.1%). The median time of FFLP was not reached, and PFS and OS times were 4.0 (95% confidence interval [CI], 3.6–4.5) and 14.8% (95% CI, 12.5–17.2) months, respectively. The 1-year FFLP, PFS, and OS rates were 60% (95% CI, 43.8–76.2), 0%, and 85.7% (95% CI, 75.9–95.5), respectively. Grade 3 or higher hematologic adverse events (AEs) were not observed, but grade 3 non- hematologic AEs unrelated to RT were observed in one patient. Conclusions: The addition of RT may be feasible in patients with advanced HCC treated with atezolizumab plus bevacizumab. However, further studies are required to validate these findings.
( Sang Youn Hwang ),( Sun Mi Lee ),( Jeong Woo Lim ),( Gi Jung Jeon ),( Hye Won Lee ) 대한간암학회 2021 대한간암학회지 Vol.21 No.2
Sorafenib is the oldest first line systemic treatment in patients with advanced hepatocellular carcinoma (HCC) and has been used exclusively for nearly 10 years. The superiority of administering a combination of atezolizumab plus bevacizumab (AteBeva) compared to sorafenib as first line systemic treatment for unresectable HCC was recently proven during the IMbrave150 Phase III randomized trial. While clinicians can expect improved responses and treatment outcomes due to the good results of the IMbrave 150 trial, they must also consider that atezolizumab can cause various immune-related adverse events (IrAEs). Based on the above suggestions, we herein present a case of HCC with lymph node metastasis who achieved complete remission following treatment with AteBeva and developed an IrAE (adrenal insufficiency). Further study of real-life data regarding combination therapy with AteBeva is needed to manage patients with advanced HCC. (J Liver Cancer 2021;21:177-180)