Zusammenfassung
Immunmodulatorische Checkpointinhibitoren gegen das PD-1-Protein gelten als neue Therapieoptionen vieler solider Tumoren. Wir berichten über eine Patientin, die im Rahmen eines metastasierten Nierenzellkarzinoms eine immunmodulatorische Therapie mit Nivolumab erhielt und an den Folgen einer lymphozytären Myokarditis als seltenes immunologisches, therapieassoziiertes Ereignis 2 Wochen nach Therapiebeginn verstarb. Die Todesursache konnte erst durch eine Obduktion geklärt werden. Der Fallbericht verdeutlicht demnach die Wichtigkeit und Notwendigkeit klinischer Sektionen als Instrument zur Qualitätssicherung und Aufklärung therapieassoziierter Nebenwirkungen.
Abstract
Immune checkpoint inhibitors against the PD-1 protein offer a new therapy option for many solid cancers. We report a patient with metastatic renal cell cancer treated with Nivolumab. As a rare immune-mediated adverse event, we describe a fatal lymphocytic myocarditis two weeks after starting immune therapy. The cause of death was first diagnosed at autopsy. This case report underlines the importance and need of clinical autopsies as an instrument of quality assurance and detection of rare therapy-induced adverse effects.
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R. Sauer, P. Kiewe, M. Desole, M. Schuler, F. Theissig, A. Roth und T. Mairinger geben an, dass kein Interessenkonflikt besteht.
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H.A. Baba, Essen
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Sauer, R., Kiewe, P., Desole, M. et al. Lymphozytäre Myokarditis unter Nivolumabtherapie bei metastasiertem klarzelligen Nierenzellkarzinom. Pathologe 38, 535–539 (2017). https://doi.org/10.1007/s00292-017-0349-y
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DOI: https://doi.org/10.1007/s00292-017-0349-y
Schlüsselwörter
- Nierenzellkarzinom
- PD-1-Inhibition
- Immunologisches, therapieassoziiertes Ereignis
- Lymphozytäre Myokarditis
- Parvovirus B19