3児の親さん薬剤師のブログ

とある薬剤師です。感染症治療を考える素材をちょこっと提供。noteもあります https://note.com/twin1980

Hair Repigmentation During Immunotherapy Treatment With an Anti-Programmed Cell Death 1 and Anti-Programmed Cell Death Ligand 1 Agent for Lung Cancer.

Journal Club

学生が担当

最近話題の免疫療法による毛髪の色素沈着についてのBrief Reportです。

https://jamanetwork.com/journals/jamadermatology/article-abstract/2642914

 

先日、2期の薬学実習が終わりました。

 

Journal Clubは期間中に3回学生が担当してます。

学生からは毎回好評です。

多職種の中で、Journal Clubを担当し、議論することは、

チーム医療において、良い影響があると信じてます。

 

薬学生参加のメリット

・多様性の体験 : 職種の違いによるエビデンスの捉え方を体感できること。

課題

・翻訳中心で、批判的吟味の強化が求められる。

 

さて、

Hair Repigmentation During Immunotherapy Treatment With an Anti-Programmed Cell Death 1 and Anti-Programmed Cell Death Ligand 1 Agent for Lung Cancer.

 

Importance  New targeted therapies for cancer have been released in recent years, opening new horizons in the treatment of patients with cancer. However, their related adverse events (AE) are not fully characterized. Hair repigmentation (HR) is a nondescribed effect secondary to anti–programmed cell death 1 (anti–PD-1) and anti–programmed cell death ligand 1 (anti–PD-L1 ) therapy for treatment of lung cancer (LC), in opposition to the vitiligo reactions that develop during melanoma treatment.

Objective  To describe a new adverse event occurring during anti–PD-1/anti–PD-L1 therapy for LC.

Design, Setting, and Participants  A case series from a descriptive observation of 14 patients with HR after anti–PD-1/anti–PD-L1 treatment, recruited between September and December, 2016, who were followed up to detect whether they developed cutaneous AE at the time HR was detected. The patients had all been treated in the dermatology department at Hospital Universitari Germans Trias i Pujol, Badalona, Spain.

Main Outcomes and Measures  Clinical observation of HR during anti–PD-1/anti–PD-L1 therapy for LC, proved by comparing old pictures provided by the patients and recent pictures taken during the follow-up.

Results  Fourteen patients (13 men and 1 woman; mean age, 64.9 years) receiving anti–PD-1 or anti–PD-L1 therapy for non–small-cell lung cancer (NSCLC) presented hair repigmentation during follow-up. This hair repigmentation consisted in a diffuse darkening of the hair in 13 of 14 patients, or in black patches between white hairs in 1. Thirteen of 14 patients presented a good clinical response to the treatment, with at least stable disease, and only 1 had to stop the therapy after only 4 cycles of treatment owing to a life-threatening progression of the disease.

Conclusions and Relevance  We present to our knowledge the first report of hair repigmentation owing to anti–PD-1/anti–PD-L1 therapy for lung cancer in a series of 14 patients. Hair repigmentation may be a good response marker in patients receiving anti-PD1/anti–PD-L1 therapy for LC.

 

f:id:akinohanayuki:20171123075516p:plain

f:id:akinohanayuki:20171123075520p:plain

 

感想

・メラノーマに対するNIVO治療おける白斑のように、効果予測因子となり得る可能性があり、興味深い。

・後頭部から、毛髪の色素沈着が始まるので、後頭部をアセスメント。

・P3試験で報告のないAE、稀なのか、想定外であったのか?

・試験レベルを上げた報告を待ちたい。

・私もフィジカルアセスメントの確認項目に髪色も追加したい。

 

 

がん免疫療法ガイドライン

がん免疫療法ガイドライン

 

 

 

EBMの手法による 肺癌診療ガイドライン 2016年版 悪性胸膜中皮腫・胸腺腫瘍含む

EBMの手法による 肺癌診療ガイドライン 2016年版 悪性胸膜中皮腫・胸腺腫瘍含む

 

 

2017年2期の学生が担当したJournal Club

 

akinohanayuki.hatenablog.com

akinohanayuki.hatenablog.com