Sintilimab-induced inflammatory myopathy in a patient with esophageal cancer: a case report

Hong, Guo1,2,3; Zhao, Haina4; Yin, Yuxuan5; Shen, Hailin3; Zeng, Zhaohao1,2; Yang, Jianwei6; Zhang, Lili7

2023-10-18

10.3389/fimmu.2023.1253463

FRONTIERS IN IMMUNOLOGY   Impact Factor & Quartile

1664-3224

The use of immune checkpoint inhibitors (ICIs) has shown remarkable efficacy in the treatment of various malignancies, significantly reshaping cancer treatment. However, as a result of the widespread use of ICIs, several immune-related adverse events (iRAEs) have emerged, some of which can be rare and potentially fatal. In this paper, we reported the earliest case of Sintilimab used in the treatment of esophageal cancer with severe inflammatory myopathy (involving the cardiac, respiratory, and skeletal muscles)in China. This patient was an elderly female who presented to our institution with progressive limb weakness and ptosis. Prior to the onset of symptoms, the patient had undergone a radical esophagectomy for esophageal cancer, experienced several cycles of of radiotherapy and chemotherapy, as well as two doses of Sintilimab treatment. Shortly after initiating immunotherapy, the patient developed symptoms including bilateral ptosis, limb weakness, and difficulty swallowing and breathing. The levels of creatine kinase and troponin I in the patient's blood were significantly elevated, and positive results were observed for anti-skeletal and anti-cardiac muscle antibodies, indicating that the patient might be developing ICIs-related inflammatory myopathy. Fortunately, the patient responded well to treatment including corticosteroids, plasmapheresis, intravenous immunoglobulin, and other supportive therapies. Here, we discuss the incidence, mechanisms, and management strategies of fatal iRAEs. Early detection and timely intervention may be critical in reducing the incidence and mortality rates of iRAEs and improving patient outcomes.

immune checkpoint inhibitors Sintilimab PD-1 immune-related adverse events inflammatory myopathy

SCI

English

First

Immunology

Immunology

WOS:001091127600001

FRONTIERS MEDIA SA

Web of Science

1.Jinan Univ, Southern Univ Sci & Technol, Shenzhen Peoples Hosp, Affiliated Hosp 1,Clin Med Coll 2,Dept Neurol, Shenzhen, Peoples R China
2.Shenzhen Peoples Hosp, Shenzhen Clin Res Ctr Geriatr, Shenzhen, Peoples R China
3.Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Dept Neurol,Nantong Branch, Nantong, Peoples R China
4.Yangzhou Univ, Jiangsu Subei Peoples Hosp, Inst Brain Sci, Dept Neurol, Yangzhou, Peoples R China
5.Yizheng Peoples Hosp, Dept Neurol, Yangzhou, Peoples R China
6.Jinan Univ, Guangdong Prov Gen Hosp 2, Sch Med, Dept Ultrasound, Guangzhou, Peoples R China
7.Yangzhou Univ, Jiangdu Peoples Hosp, Dept Neurol, Yangzhou, Peoples R China

Hong, Guo,Zhao, Haina,Yin, Yuxuan,et al. Sintilimab-induced inflammatory myopathy in a patient with esophageal cancer: a case report[J]. FRONTIERS IN IMMUNOLOGY,2023,14.

Hong, Guo.,Zhao, Haina.,Yin, Yuxuan.,Shen, Hailin.,Zeng, Zhaohao.,...&Zhang, Lili.(2023).Sintilimab-induced inflammatory myopathy in a patient with esophageal cancer: a case report.FRONTIERS IN IMMUNOLOGY,14.

Hong, Guo,et al."Sintilimab-induced inflammatory myopathy in a patient with esophageal cancer: a case report".FRONTIERS IN IMMUNOLOGY 14(2023).