Myositis/Myasthenia after Pembrolizumab in a Bladder Cancer Patient with an Autoimmunity-Associated HLA: Immune–Biological Evaluation and Case Report

Pembrolizumab (mAb to PD-1) has been recently approved for the therapy of pretreated urothelial cancer. Despite the efficacy, it is often accompanied by unpredictable and sometime severe immune-related (ir) adverse events (AEs). Here, we report the clinical and immune–biological characterization of...

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Detalles Bibliográficos
Autores principales: Botta, Cirino, Agostino, Rita Maria, Dattola, Vincenzo, Cianci, Vittoria, Calandruccio, Natale Daniele, Bianco, Giovanna, Mafodda, Antonino, Maisano, Roberto, Iuliano, Eleonora, Orizzonte, Giovanna, Mazzacuva, Domenico, Falzea, Antonia Consuelo, Saladino, Rita Emilena, Giannicola, Rocco, Restifo, Giorgio, Aguglia, Umberto, Caraglia, Michele, Correale, Pierpaolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230397/
https://www.ncbi.nlm.nih.gov/pubmed/34200673
http://dx.doi.org/10.3390/ijms22126246
Descripción
Sumario:Pembrolizumab (mAb to PD-1) has been recently approved for the therapy of pretreated urothelial cancer. Despite the efficacy, it is often accompanied by unpredictable and sometime severe immune-related (ir) adverse events (AEs). Here, we report the clinical and immune–biological characterization of a patient with a metastatic bladder cancer who developed myositis signs (M) and a myasthenia-like syndrome (MLS) during treatment with pembrolizumab. The patient presented an autoimmunity-associated HLA haplotype (HLA-A*02/HLA-B*08/HLA-C*07/HLA-DRB1*03) and experienced an increase in activated CD8 T-cells along the treatment. The symptomatology regressed after pembrolizumab discontinuation and a pyridostigmine and steroids-based therapy. This is the first report of concurrent M and MLS appearance in cancer patients receiving pembrolizumab. More efforts are needed to define early the risk and the clinical meaning of irAEs in this setting.

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