Paraneoplastic myelitis associated with durvalumab treatment for extensive-stage small cell lung cancer

被引：0
作者：
Lan Wang
Haiyan Lou
Bo Li
Jun Li
Yun-Mei Yang
机构：
[1] The First Affiliated Hospital,Department of Geriatrics, College of Medicine
[2] Zhejiang University,Department of Radiology
[3] The First Affiliated Hospital,Department of Pathology
[4] Zhejiang University School of Medicine,undefined
[5] The First Affiliated Hospital,undefined
[6] Zhejiang University School of Medicine,undefined
来源：
Investigational New Drugs | 2022年 / 40卷
关键词：
Durvalumab; Immune checkpoint inhibitor; Immune-related adverse effects; Paraneoplastic neurologic syndromes; Programmed cell death ligand protein 1; Small-cell Lung cancer;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Paraneoplastic neurologic syndromes(PNSs) caused by immune checkpoint inhibitors(ICIs) is rare and requires clinicians to differentiate between disease progression and immune-related adverse effects(irAEs). We hereby report the case of immune-related myelitis accompanied by positive paraneoplastic autoantibodies following durvalumab treatment for extensive-stage small cell lung cancer (ES-SCLC). A 70-year-old Chinese woman with ES-SCLC was administered durvalumab with etoposid-platinum(EP) as first-line treatment. Four cycles after treatment with EP plus ICI, she developed immune-related myelitis with positive paraneoplastic autoantibodies (CV2, SOX1, ZIC4). Spinal MRI showed diffuse abnormal signal shadow in the cervicothoracic spinal cord. She was discontinued for chemotherapy, and treated with high-dose steroids, intravenous immunoglobulin and plasmapheresis, maintenance therapy with steroids resulted in a favorable neurologic outcome. This is the first report of durvalumab-related PNSs. We supposed that the development of paraneoplastic myelitis was causally related to immune activation by durvalumab. Prompt diagnosis and therapeutic intervention are essential for the effective treatment of paraneoplastic myelitis.
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页码：151 / 156
页数：5
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