Bulozni Pemfigoid Kao Neželjeni Efekat Terapije Nivolumabom − Prikaz Slučaja

Radosavljević, Jelena; Salatić, Igor; Mijušković, Željko; Petrov, Nenad; Dinić, Miroslav; Kandolf, Lidija

doi:10.2478/sjdv-2024-0009

Abstract

Inhibitori kontrolnih tačaka, anti-PD-1 antitelo nivolumab i anti-CTLA-4 antitelo ipilimumab, revolucionirali su lečenje raka u protekloj deceniji. Oslobađanjem kočnica imunskog sistema, dovode do aktivacije antitumorskog ćelijskog imuniteta, što dovodi do dugotrajnih odgovora kod nekoliko vrsta tumora, uključujući metastatski melanom, karcinom renalnih ćelija, skvamozni i metastatski nesitnoćelijski karcinom pluća. Međutim, nespecifična aktivacija imunskog sistema često dovodi do neželjenih efekata koji mogu zahvatiti sve organske sisteme, ali najčešće kožu. Najčešće kutane neželjene reakcije su makulopapularni osip i svrab. Retke, ali ozbiljne, po život opasne reakcije, poput buloznih dermatoza, uključujući bulozni pemfigoid, takođe se mogu javiti. Predstavljamo slučaj buloznog pemfigoida tokom lečenja metastatskog melanoma nivolumabom i ipilimumabom. Prepoznavanje i rano lečenje imunski posredovanih neželjenih efekata od suštinskog su značaja za ograničavanje trajanja i težine neželjenih efekata i za sprečavanje prekida kontinuiteta lečenja, te uspostavljanja i održavanja efikasnosti terapije.

References

Guo L, Zhang H, Chen B. Nivolumab as programmed death-1 (PD-1) inhibitor for targeted immunotherapy in tumor. J Cancer. 2017;8(3):410-6.
Search in Google Scholar Back to article
Savoia P, Astrua C, Fava P. Ipilimumab (Anti-Ctla-4 Mab) in the treatment of metastatic melanoma: effectiveness and toxicity management. Hum Vaccin Immunother. 2016;12(5):1092-101.
Search in Google Scholar Back to article
Champiat S, Lambotte O, Barreau E, Belkhir R, Berdelou A, Carbonnel F, et al. Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper. Ann Oncol. 2016;27(4):559-74.
Search in Google Scholar Back to article
Liu M, Yuan M, Sun W, Li Z, Zhou X, Wang C. Clinical characterization, treatment, and outcome of nivolumab-induced bullous pemphigoid. Invest New Drugs. 2023;41(6):802-7.
Search in Google Scholar Back to article
Anastasopoulou A, Papaxoinis G, Diamantopoulos P, Christofidou E, Benopoulou O, Stratigos A, et al. Bullous pemphigoid-like skin lesions and overt eosinophilia in a patient with melanoma treated with nivo lumab: case report and review of the literature. J Immu nother. 2018; 41(3):164-7.
Search in Google Scholar Back to article
Mazumder A, Darji K, Smith K, Guo M. Two rare cases of bullous pemphigoid associated with immune checkpoint inhibitors. BMJ Case Rep. 2022;15(12):e253059.
Search in Google Scholar Back to article
Miyamoto D, Santi CG, Aoki V, Maruta CW. Bullous pemphigoid. An Bras Dermatol. 2019;94(2):133-46.
Search in Google Scholar Back to article
Holtsche MM, Boch K, Schmidt E. Autoimmune bullous dermatoses. J Dtsch Dermatol Ges. 2023; 21(4):405-12.
Search in Google Scholar Back to article
U.S. Department of Health and Human Services. Common terminology criteria for adverse events (CTCAE) version 5.0 [Internet]. 2017 [cited 2025 Jun 5]. Available from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pd
Search in Google Scholar Back to article
Borradori L, Van Beek N, Feliciani C, Tedbirt B, Antiga E, Bergman R, et al. Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol. 2022;36 (10) :1689-704.
Search in Google Scholar Back to article
Lopez AT, Geskin L. A case of nivolumab-induced bullous pemphigoid: review of dermatologic toxicity associated with programmed cell death protein-1/programmed death ligand-1 inhibitors and recommendations for diagnosis and management. Oncologist. 2018;23(10):1119-26.
Search in Google Scholar Back to article
Olsen E, Svoboda SA, Saikaly SK, Missall TA, Motaparthi K. Delayed onset of bullous pemphigoid secondary to nivolumab. Cureus. 2023;15(8):e43230.
Search in Google Scholar Back to article
Hansen I, Gebhardt C, Booken N, Schneider SW. Successful treatment of checkpoint inhibitor-associated bullous pemphigoid with dupilumab in a patient with angiosarcoma. JDDG - Journal of the German Society of Dermatology. 2024;22(4):587-9.
Search in Google Scholar Back to article
Merli M, Accorinti M, Romagnuolo M, Marzano A, Di Zenzo G, Moro F, et al. Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience. Front Med (Lausanne). 2023;10:1208418.
Search in Google Scholar Back to article
Lopez AT, Khanna T, Antonov N, Audrey-Bayan C, Geskin L. A review of bullous pemphigoid associated with PD-1 and PD-L1 inhibitors. Int J Dermatol. 2018; 57-(6):664-9.
Search in Google Scholar Back to article
Chen ST, Semenov YR, Alloo A, Bach DQ, Betof Warner A, Bougrine A, et al. Defining D-irAEs: consensus-based disease definitions for the diagnosis of dermato-logic adverse events from immune checkpoint inhibitor therapy. J Immunother Cancer. 2024;12 (4):e007675.
Search in Google Scholar Back to article
Choi J, Anderson R, Blidner A, Cooksley T, Dougan M, Glezerman I, et al. Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of severe dermatological toxicities from checkpoint inhibitors. Support Care Cancer. 2020;28(12):6119-28.
Search in Google Scholar Back to article
Wang M, Wang J, Shi B. Case report: dupilumab for the treatment of bullous pemphigoid. Dermatol Ther. 2022;35(7):e15541.
Search in Google Scholar Back to article
Seidman JS, Eichenfield DZ, Orme CM. Dupilumab for bullous pemphigoid with intractable pruritus. Dermatol Online J. 2019;25(11):13030/qt25q9w6r9.
Search in Google Scholar Back to article
Kuo AM, Gu S, Stoll J, Moy AP, Dusza SW, Gordon A, et al. Management of immune-related cutaneous adverse events with dupilumab. J Immunother Cancer. 2023;11(6):e007324.
Search in Google Scholar Back to article

Bulozni Pemfigoid Kao Neželjeni Efekat Terapije Nivolumabom − Prikaz Slučaja

Abstract

Paradigm

My account