Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance
Dermatomyositis (DM) is an uncommon systemic autoimmune disorder classified as one of the idiopathic inflammatory myopathies (IIM). DM could also represent a manifestation of an underlying neoplasm with a relative risk of cancer globally ranging from 3% to 8%. Owing to the strong connection between...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1558964/full |
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| author | Mariangela Torniai Giuseppe Pio Martino Calogero Gucciardino Stefano Angelici Renato Bisonni |
| author_facet | Mariangela Torniai Giuseppe Pio Martino Calogero Gucciardino Stefano Angelici Renato Bisonni |
| author_sort | Mariangela Torniai |
| collection | DOAJ |
| description | Dermatomyositis (DM) is an uncommon systemic autoimmune disorder classified as one of the idiopathic inflammatory myopathies (IIM). DM could also represent a manifestation of an underlying neoplasm with a relative risk of cancer globally ranging from 3% to 8%. Owing to the strong connection between immunosurveillance and cancer progression, the management of paraneoplastic DM represents a challenging issue. To complicate matters is the advent of cancer immunotherapy, that might interfere with self-tolerance with a true risk of previous autoimmune disorders re-exacerbation. We report the case of a 50-year-old patient with advanced urothelial bladder cancer and preexisting paraneoplastic DM treated with pembrolizumab. On the basis of our experience, previous paraneoplastic DM might not necessarily represent an absolute contraindication for ICIs treatment. Furthermore, this case might suggest a role of intravenous immunoglobulins (IVIG) in preventing DM reactivation, underling the importance of a multidisciplinary approach. |
| format | Article |
| id | doaj-art-20a467d318eb4f4b85ee12efccf40121 |
| institution | DOAJ |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-20a467d318eb4f4b85ee12efccf401212025-08-20T02:56:02ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-03-011610.3389/fimmu.2025.15589641558964Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balanceMariangela Torniai0Giuseppe Pio Martino1Calogero Gucciardino2Stefano Angelici3Renato Bisonni4Unità Operativa Complessa (UOC) Oncologia, Ospedale Murri, Fermo, ItalyUnità Operativa Complessa (UOC) Medicina Interna, Ospedale Murri, Fermo, ItalyUnità Operativa Complessa (UOC) Oncologia, Ospedale Murri, Fermo, ItalyUnità Operativa Complessa (UOC) Medicina Interna, Ospedale Murri, Fermo, ItalyUnità Operativa Complessa (UOC) Oncologia, Ospedale Murri, Fermo, ItalyDermatomyositis (DM) is an uncommon systemic autoimmune disorder classified as one of the idiopathic inflammatory myopathies (IIM). DM could also represent a manifestation of an underlying neoplasm with a relative risk of cancer globally ranging from 3% to 8%. Owing to the strong connection between immunosurveillance and cancer progression, the management of paraneoplastic DM represents a challenging issue. To complicate matters is the advent of cancer immunotherapy, that might interfere with self-tolerance with a true risk of previous autoimmune disorders re-exacerbation. We report the case of a 50-year-old patient with advanced urothelial bladder cancer and preexisting paraneoplastic DM treated with pembrolizumab. On the basis of our experience, previous paraneoplastic DM might not necessarily represent an absolute contraindication for ICIs treatment. Furthermore, this case might suggest a role of intravenous immunoglobulins (IVIG) in preventing DM reactivation, underling the importance of a multidisciplinary approach.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1558964/fullimmunotherapyparaneoplastic syndromeautoimmune diseasedermatomyositisurothelial carcinomapembrolizumab |
| spellingShingle | Mariangela Torniai Giuseppe Pio Martino Calogero Gucciardino Stefano Angelici Renato Bisonni Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance Frontiers in Immunology immunotherapy paraneoplastic syndrome autoimmune disease dermatomyositis urothelial carcinoma pembrolizumab |
| title | Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance |
| title_full | Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance |
| title_fullStr | Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance |
| title_full_unstemmed | Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance |
| title_short | Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance |
| title_sort | case report pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma searching for balance |
| topic | immunotherapy paraneoplastic syndrome autoimmune disease dermatomyositis urothelial carcinoma pembrolizumab |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1558964/full |
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