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Case Report: Imaging immune checkpoint inhibitor-induced yin-yang effects in the brain.


ABSTRACT:

Background

Treatment with immune checkpoint inhibitors (ICI) can induce durable responses in cancer patients, but it is commonly associated with serious immune-related side effects. Both effects are suggested to be mediated by CD8+ T-cell infiltration. Whole body CD8+ T-cell distribution can be visualized by PET imaging of a 89Zr-labeled anti-humanCD8a minibody, currently investigated in a phase 2b trial.

Main body

An adult patient diagnosed with metastatic melanoma developed ICI-related hypophysitis after two courses of combined immunotherapy (ipilimumab (3 mg/kg) and nivolumab (1 mg/kg) at 3 weeks interval). On a [89Zr]Zr-crefmirlimab berdoxam PET/CT scan, made 8 days before clinical symptoms occurred, increased CD8+ T-cell infiltration in the pituitary gland was detected. Simultaneously, tracer uptake in a cerebral metastasis was increased, indicating ICI-induced tumor infiltration by CD8+ T-cells.

Conclusions

The observations in this case report underscore the role of CD8+ T-cell in non-tumor tissues in ICI-related toxicity. In addition, it illustrates a potential role for molecular imaging by PET/CT for investigation and monitoring of ICI-induced effects.

SUBMITTER: Bol KF 

PROVIDER: S-EPMC10272360 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Case Report: Imaging immune checkpoint inhibitor-induced yin-yang effects in the brain.

Bol K F KF   Peeters E E   van Herpen C M L CML   Westdorp H H   Aarntzen E H J G EHJG  

Frontiers in immunology 20230602


<h4>Background</h4>Treatment with immune checkpoint inhibitors (ICI) can induce durable responses in cancer patients, but it is commonly associated with serious immune-related side effects. Both effects are suggested to be mediated by CD8+ T-cell infiltration. Whole body CD8+ T-cell distribution can be visualized by PET imaging of a 89Zr-labeled anti-humanCD8a minibody, currently investigated in a phase 2b trial.<h4>Main body</h4>An adult patient diagnosed with metastatic melanoma developed ICI-  ...[more]

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