Complete remission of reactive cutaneous capillary endothelial proliferation caused by the programmed cell death-1 inhibitor camrelizumab achieved through thalidomide monotherapy: A case report

Wang,Chunxiu; Lei,Kaijian; Jia,Yuming; Jiang,Zuxin; Wang,Shanbing

doi:10.3892/etm.2023.12023

Complete remission of reactive cutaneous capillary endothelial proliferation caused by the programmed cell death-1 inhibitor camrelizumab achieved through thalidomide monotherapy: A case report

Authors:
- Chunxiu Wang
- Kaijian Lei
- Yuming Jia
- Zuxin Jiang
- Shanbing Wang
View Affiliations

Affiliations: Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan 644000, P.R. China, Department of Orthopedics, The Second People's Hospital of Yibin, Yibin, Sichuan 644000, P.R. China
Published online on: May 16, 2023 https://doi.org/10.3892/etm.2023.12023
Article Number: 324

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Reactive cutaneous capillary endothelial proliferation (RCCEP) is a common adverse effect of the anti-programmed cell death-1 (PD-1) monoclonal antibody camrelizumab and usually occurs on the skin. This condition causes bleeding nodules of varying severity depending on disease grade; these affect a person's appearance and quality of life. The exact mechanism remains elusive and its occurrence in visceral organs has not been previously reported, to the best of our knowledge. Furthermore, there is currently a lack of standard, uniform treatments. The present study reported on a patient who experienced RCCEP during treatment with camrelizumab and benefited greatly from thalidomide, which caused no serious adverse events. An elderly Chinese female initially diagnosed with stage II endometrial cancer had previously undergone surgery, radiotherapy and intravenous chemotherapy but developed multiple metastases in the peritoneum and vaginal remnant. The patient was subsequently prescribed camrelizumab after systemic treatment failed. Soon after commencing treatment with this PD-1 inhibitor, the patient developed RCCEP, whereupon oral low-dose thalidomide monotherapy (100 mg nightly) was prescribed. At two weeks after commencing thalidomide, the RCCEP symptoms were alleviated. Based on this patient's successful treatment, it is suggested that low-dose thalidomide may be an alternative intervention for patients with camrelizumab-induced RCCEP.

View Figures

View References

1	Fang W, Yang Y, Ma Y, Hong S, Lin L, He X, Xiong J, Li P, Zhao H, Huang Y, et al: Camrelizumab (SHR-1210) alone or in combination with gemcitabine plus cisplatin for nasopharyngeal carcinoma: Results from two single-arm, phase 1 trials. Lancet Oncol. 19:1338–1350. 2018.PubMed/NCBI View Article : Google Scholar
2	Mo H, Huang J, Xu J, Chen X, Wu D, Qu D, Wang X, Lan B, Wang X, Xu J, et al: Safety, anti-tumour activity, and pharmacokinetics of fixed-dose SHR-1210, an anti-PD-1 antibody in advanced solid tumours: A dose-escalation, phase 1 study. Br J Cancer. 119:538–545. 2018.PubMed/NCBI View Article : Google Scholar
3	Teng Y, Guo R, Sun J, Jiang Y and Liu Y: Reactive capillary hemangiomas induced by camrelizumab (SHR-1210), an anti-PD-1 agent. Acta Oncol. 58:388–389. 2019.PubMed/NCBI View Article : Google Scholar
4	Chen X, Ma L, Wang X, Mo H, Wu D, Lan B, Qu D, Zhang H, Huang J and Xu BH: Reactive capillary hemangiomas: A novel dermatologic toxicity following anti-PD-1 treatment with SHR-1210. Cancer Biol Med. 16:173–181. 2019.PubMed/NCBI View Article : Google Scholar
5	Chinese Society of Clinical Oncology (CSCO): Management of Immune Checkpoint Inhibitor-Related Toxicity, 1. People's Health Publishing House, Beijing, 2020.
6	Rispoli M, Savastano MC and Lumbroso B: Quantitative vascular density changes in choriocapillaris around CNV after anti-VEGF treatment: Dark halo. Ophthalmic Surg Lasers Imaging Retina. 49:918–924. 2018.PubMed/NCBI View Article : Google Scholar
7	Vacca A, Scavelli C, Montefusco V, Di Pietro G, Neri A, Mattioli M, Bicciato S, Nico B, Ribatti D, Dammacco F and Corradini P: Thalidomide downregulates angiogenic genes in bone marrow endothelial cells of patients with active multiple myeloma. J Clin Oncol. 23:5334–5346. 2005.PubMed/NCBI View Article : Google Scholar
8	Keifer JA, Guttridge DC, Ashburner BP and Baldwin AS Jr: Inhibition of NF-kappa B activity by thalidomide through suppression of IkappaB kinase activity. J Biol Chem. 276:22382–22387. 2001.PubMed/NCBI View Article : Google Scholar
9	Melchert M and List A: The thalidomide saga. Int J Biochem Cell Biol. 39:1489–1499. 2007.PubMed/NCBI View Article : Google Scholar
10	Raje N and Anderson KC: Thalidomide and immunomodulatory drugs as cancer therapy. Curr Opin Oncol. 14:635–640. 2002.PubMed/NCBI View Article : Google Scholar
11	Yuan JH, Yang F, Wang F, Ma JZ, Guo YJ, Tao QF, Liu F, Pan W, Wang TT, Zhou CC, et al: A long noncoding RNA activated by TGF-β promotes the invasion-metastasis cascade in hepatocellular carcinoma. Cancer Cell. 25:666–681. 2014.PubMed/NCBI View Article : Google Scholar
12	Song G, Zhang FF and Cheng HD: Thalidomide for prevention of camrelizumab-induced reactive cutaneous capillary endothelial proliferation. Australas J Dermatol. 63:217–221. 2022.PubMed/NCBI View Article : Google Scholar
13	Li Q, Zhou Y, He W, Ren X, Zhang M, Jiang Y, Zhou Z and Luan Y: Platelet-armored nanoplatform to harmonize janus-faced IFN-γ against tumor recurrence and metastasis. J Control Release. 338:33–45. 2021.PubMed/NCBI View Article : Google Scholar
14	Zhang M, Qin X, Zhao Z, Du Q, Li Q, Jiang Y and Luan Y: A self-amplifying nanodrug to manipulate the Janus-faced nature of ferroptosis for tumor therapy. Nanoscale Horiz. 7:198–210. 2022.PubMed/NCBI View Article : Google Scholar
15	Bhardwaj M, Chiu MN and Pilkhwal Sah S: Adverse cutaneous toxicities by PD-1/PD-L1 immune checkpoint inhibitors: Pathogenesis, treatment, and surveillance. Cutan Ocul Toxicol. 41:73–90. 2022.PubMed/NCBI View Article : Google Scholar
16	Qin S, Ren Z, Meng Z, Chen Z, Chai X, Xiong J, Bai Y, Yang L, Zhu H, Fang W, et al: Camrelizumab in patients with previously treated advanced hepatocellular carcinoma:A multicentre,open-label, parallel-group, randomised, phase 2 trial. Lancet Oncol. 21:571–580. 2020.PubMed/NCBI View Article : Google Scholar
17	Mok TSK, Wu YL, Kudaba I, Kowalski DM, Cho BC, Turna HZ, Castro G Jr, Srimuninnimit V, Laktionov KK, Bondarenko I, et al: Pembrolizumab versus chemotherapy for previously untreated, PD-L1-expressing, locally advanced or metastatic non-small-cell lung cancer(KEYNOT-042):A randomised, open-label, controlled, phase 3 trail. Lancet. 393:1819–1830. 2019.PubMed/NCBI View Article : Google Scholar
18	Si L, Zhang X, Shu Y, Pan H, Wu D, Liu J, Lou F, Mao L, Wang X, Wen X, et al: A phase Ib study of Pembrolizumab as second-line therapy for Chinese patients with advanced or metastatic melanoma(KEYNOTE-151). Transl Oncol. 12:828–835. 2019.PubMed/NCBI View Article : Google Scholar
19	Song Y, Wu J, Chen X, Lin T, Cao J, Liu Y, Zhao Y, Jin J, Huang H, Hu J, et al: A single-arm, multicenter, phase II study of camrelizumab in relapsed or refractory classical hodgkin lymphoma. Clin Cancer Res. 25:7363–7369. 2019.PubMed/NCBI View Article : Google Scholar
20	Wang F, Qin S, Sun X, Ren Z, Meng Z, Chen Z, Chai X, Xiong J, Bai Y, Yang L, et al: Reactive cutaneous capillary endothelial proliferation in advanced hepatocellular carcinoma patients treated with camrelizumab:data derived from a multicenter phase 2 trial. J Hematol Oncol. 13(47)2020.PubMed/NCBI View Article : Google Scholar
21	Yu Q and Wang WX: Camrelizumab (SHR-1210) leading to reactive capillary hemangioma in the gingiva:A case report. World J Clin Cases. 8:624–629. 2020.PubMed/NCBI View Article : Google Scholar
22	Qin SK and Wang F: Camrelizumab induced cutaneous capillary endothelial proliferation Clinical expert consensus. Chin Clin Oncol. 25:840–846. 2020.(In Chinese).
23	Huang J, Xu J, Chen Y, Zhuang W, Zhang Y, Chen Z, Chen J, Zhang H, Niu Z, Fan Q, et al: Camrelizumab versus investigator's choice of chemotherapy as second-line therapy for advanced or metastatic oesophageal squamous cell carcinoma (Escort):A multicentre, randomised, open-label, phase 3 study. Lancet Oncol. 21:832–842. 2020.PubMed/NCBI View Article : Google Scholar
24	Aso M, Toi Y, Sugisaka J, Aiba T, Kawana S, Saito R, Ogasawara T, Tsurumi K, Ono K, Shimizu H, et al: Association between skin reaction and clinical benefit in patients treated with anti-programmed cell death 1 monotherapy for advanced non-small cell lung cancer. Oncologist. 25:e536–e544. 2022.PubMed/NCBI View Article : Google Scholar
25	Spratlin JL, Mulder KE and Mackey JR: Ramucirumab (IMC-1121B):A novel attack on angiogenesis. Future Oncol. 6:1085–1094. 2010.PubMed/NCBI View Article : Google Scholar
26	Lee SJ, Lee SY, Lee WS, Yoo JS, Sun JM, Lee J, Park HS, Park JO, Ahn MJ, Lim HY, et al: Phase I trial and pharmacokinetic study of tanibirumab, a fully human monoclonal antibody to vascular endothelial growth factor receptor 2, in patients with refractory solid tumors. Invest New Drugs. 35:782–790. 2017.PubMed/NCBI View Article : Google Scholar
27	Ton NC, Parker GJ, Jackson A, Mullamitha S, Buonaccorsi GA, Roberts C, Watson Y, Davies K, Cheung S, Hope L, et al: Phase I evaluation of CDP791, a pegylated di-Fab' conjugate that binds vascular endothelial growth factor receptor2. Clin Cancer Res. 13:7113–7118. 2007.PubMed/NCBI View Article : Google Scholar
28	Zhou C, Gao G, Wang YN, Zhao J, Chen G, Liu Z, Gu K, Huang M, He J, Chen J, et al: Efficacy of PD-1 monoclonal antibody SHR-1210 plus Apatinib in patients with advanced non-squamous NSCLC with wild-type EGFR and ALK. J Clin Oncol. 35(9112)2019.
29	Salemi M, Mohammadi S, Ghavamzadeh A and Nikbakht M: Anti-vascular endothelial growth factor targeting by curcumin and thalidomide in acute myeloid leukemia cells. Asian Pac J Cancer Prev. 18:3055–3061. 2017.PubMed/NCBI View Article : Google Scholar
30	Bodera P and Stankiewicz W: Immunomodulatory Properties of Thalidomide Analogs: Pomalidomide and lenalidomide, experimental and therapeutic applications. Recent Pat Endocr Metab Immune Drug Discov. 5:192–196. 2011.PubMed/NCBI View Article : Google Scholar
31	Bai YZ, Wang Q, Guo BS, Wang Ax, Zhang LH, Xue F, Li SY and Li YP: Effects of Thalidomide on the Expression of Collagen IA1 and Regulatory Factor in Histamine-activated Human Dermal Fibroblasts. Chin J Derm Venereol. 36:1253–1255. 2022.(In Chinese).