Rapid progression of colitis caused by lenvatinib combined with tislelizumab for hepatocellular carcinoma treatment:a case study
10.12173/j.issn.1005-0698.202305080
- VernacularTitle:仑伐替尼联合替雷利珠单抗治疗肝细胞癌致结肠炎迅速进展1例
- Author:
Jinyuan MA
1
,
2
;
Bei WANG
;
Quangang ZHU
;
Zhengxin WANG
;
Yifeng TAO
;
Xiaoyan QIU
Author Information
1. 复旦大学附属华山医院药剂科(上海 200040)
2. 同济大学附属上海皮肤病医院药剂科(上海 200443)
- Keywords:
Tyrosine kinase inhibitor;
Anti-PD-1;
Immune-related adverse reactions;
Immune-related colitis;
Case report
- From:
Chinese Journal of Pharmacoepidemiology
2024;33(3):349-354
- CountryChina
- Language:Chinese
-
Abstract:
A 62-year-old man with hepatocellular carcinoma began to take tyrosine kinase inhibitor(TKI)lenvatinib orally.After taking the medicine for a week,the patient developed watery diarrhea 2 to 3 times a day.The patient received the first dose of tislelizumab.After 20 days,the patient's diarrhea worsened,nearly 40 times a day.Lenvatinib was discontinued and the second dose of tislelizumab was received,while the diarrhea was not significantly relieved.Treatments were given upon the symptoms and diarrhea was alleviated so that lenvatinib was restarted,diarrhea aggravated again and the drug was discontinued.Acute colitis complicated with colon erosion was diagnosed by colonoscopy which was presumed to be immure-associated colitis caused by programmed cell death protein 1(PD-1).The patient was admitted to hospital for liver transplantation.After the administration of immunosuppressive drugs against graft rejection,the diarrhea gradually cleared.Diarrhea caused by anti-PD-1 antibody is usually mild.In this case,mild diarrhea caused by TKI developed rapidly into severe colitis after the first dose of anti-PD-1 antibody.Mechanism of the increasing rate of adverse effect caused by the combined use of TKI and anti-PD-1 antibodies worth further discussion.
