| 周琴.信迪利单抗联合SOX方案致胃癌患者白癜风样色素脱失和免疫相关性结肠炎1例[J].安徽医药,待发表. |
| 信迪利单抗联合SOX方案致胃癌患者白癜风样色素脱失和免疫相关性结肠炎1例 |
|
| 投稿时间：2025-09-25 录用日期：2025-11-04 |
| DOI： |
| 中文关键词: 免疫检查点抑制剂 信迪利单抗 免疫相关不良事件 白癜风样色素脱失 免疫相关性结肠炎 胃癌 |
| 英文关键词: |
| 基金项目:江西省卫生健康委科技计划(编号:202212754) |
| 作者 | 单位 | 地址 | | 周琴* | 上饶市人民医院 | 江西省上饶市庆丰大道169号 上饶市人民医院（城北院区） |
|
| 摘要点击次数: 55 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的 为信迪利单抗联合SOX化疗方案的临床安全用药提供参考 方法 临床药师参与1例信迪利单抗联合SOX化疗方案致胃癌患者白癜风样色素脱失和免疫相关性结肠炎的治疗经过,并探讨可能机制及治疗。结果 患者胃癌,予信迪利单抗注射液200 mg d 1+奥沙利铂150 mg d 1+替吉奥25 mg po bid d 1-14化疗；治疗1个周期后,患者出现白癜风样色素脱失,治疗3个周期后,患者出现腹泻,CT示结肠炎；请临床药师会诊考虑为信迪利单抗引起的白癜风样色素脱失及结肠炎,白癜风样色素脱失患者,结肠炎CTCAE 1级,无其他不适,建议继续治疗,医师采纳临床药师建议。第4个周期患者使用信迪利单抗注射液200 mg时出现面部潮红、呼吸急促、胸闷、背部肌肉疼痛等症状,停用信迪利单抗,单独使用SOX方案后白癜风样色素脱失面积未扩大、腹泻好转。结论 临床应用信迪利单抗联合SOX化疗方案时,临床药师应密切监测免疫相关不良反应(irAEs),临床药师实施药学监护工作,协同临床医师完成irAEs的早期识别与精准评估,并基于个体化病情制定干预策略,从而确保治疗过程的安全性和有效性。 |
| 英文摘要: |
| Objective To provide a reference for the clinical safe use of sintilimab combined with SOX chemotherapy.Methods Clinical pharmacists participated in the treatment of a gastric cancer patient who developed vitiligo-like depigmentation and immune-related colitis during sintilimab combined with SOX chemotherapy. The pathogenesis of these immune-related adverse events (irAEs) and corresponding interventions were analyzed.Results The patient was post-gastrectomy and received chemotherapy with sintilimab? (200 mg on day 1) + oxaliplatin (150 mg on day 1) + tegafur (25 mg twice daily on days 1~14). After one cycle of treatment, the patient developed vitiligo-like depigmentation. Following three cycles, diarrhea occurred, and computed tomography (CT) revealed colitis. These conditions were considered immune-related adverse events (irAEs) induced by sintilimab, with colitis classified as CTCAE grade 1 and no other discomforts were reported. Continuation of treatment was recommended by clinical pharmacist, and the physician adopted this advice. In the fourth cycle, when the patient was administered 200 mg of sintilimab, symptoms such as facial flushing, tachypnea, chest distress, and back muscle pain occurred. Subsequently, the administration of sintilimab was discontinued, and the SOX regimen was continued alone, the vitiligo-like depigmentation area did not expand, and diarrhea improved.Conclusion When sintilimab is used in combination with SOX chemotherapy, clinical pharmacists should closely monitor immune-related adverse events (irAEs) and systematically implement pharmaceutical care. Collaboration with clinicians is essential for the early identification and precise assessment of irAEs, enabling the development of individualized intervention strategies to ensure treatment safety and efficacy. |
|
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
