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Case Report: Seronegative polyarticular arthropathies triggered by PD-1 inhibitors
Presentation by Carole Helissey at the TAO Congress on 19/20 November 2015
The 78-year-old male patient is diagnosed with metastatic kidney cancer in 2006; the disease progresses after two lines of antiangiogenic therapy (sunitinib and axitinib). Six years later, he is included in a phase I trial evaluating a PD-1 inhibitor.
The patient develops polyarthralgia grade 3 in the shoulders, elbows, wrist, phalanx, knee, ankles and feet; many joints are swollen and painful. Ultrasound examination shows synovitis of the wrists, the ankles as well as the metacarpophalangeal and interphalangeal joints. He is diagnosed with seronegative polyarticular arthropathy, triggered by the anti-PD-1 treatment, and treated with corticosteroids. After the presentation of the case report, the case and various aspects of anti-PD-1 treatment are discussed by the expert panel.
This case report is part of the programme “AERIO meets the experts” by the French Association of Residents in Oncology (AERIO) in collaboration with an expert panel (Dr. Mario Dicato, Luxembourg Medical Center, Luxembourg; Dr. Richard Gralla, A. Einstein School of Medicine, New York, USA; Dr. Jeffrey Crawford, Duke Cancer Center, Durham, USA; Dr. Pere Gascon, Hospital Clinic, Barcelona).
Carole Helissey, Hôpital d'instruction des armées du Val-de-Grâce, Paris, France