Titre
Cytokine storm complicated by cardiogenic shock induced by anti-HER2 therapies.
Type
étude de cas
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Godinho, R.
Auteure/Auteur
Noto, A.
Auteure/Auteur
Fenwick, C.
Auteure/Auteur
Stravodimou, A.
Auteure/Auteur
Hugelshofer, S.
Auteure/Auteur
Peters, S.
Auteure/Auteur
Hullin, R.
Auteure/Auteur
Obeid, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2051-1426
Statut éditorial
Publié
Date de publication
2023-06
Volume
11
Numéro
6
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Cytokine storm induced by anti-human epidermal growth factor receptor-2 (HER2) therapies has not been reported. We report a patient with breast cancer treated with trastuzumab/pertuzumab who developed severe biventricular dysfunction and cardiogenic shock (CS) 6 months after starting double anti-HER2 therapy. The CS was accompanied by severe systemic inflammation, and cardiac MRI (cMRI) showed structural changes typical of myocardial inflammation. The immuno-inflammatory profile showed significantly increased levels of activation of the complement system, proinflammatory cytokines (IL-1β, IL-6, IL-18, IL-17A, TNF-alpha) with increased activity of classical monocytic, T helper 17 cells (Th17), CD4 T and effector memory CD8 T subsets, whereas NK cell activation was not observed. The data suggest an important role for monocytes as initiators of this FcγR-dependent antibody-dependent cytotoxicity, leading to the overactivation of an adaptive T cell response, in which Th17 cells may act in synergy with T helper 1 cells (Th1) to drive the severe cytokine release syndrome. After discontinuation of trastuzumab/pertuzumab, hypercytokinemia and complement activity normalized along with clinical recovery. Cardiac function returned to baseline within 2 months of initial presentation, together with a resolution of the myocardial inflammation on MRI.
PID Serval
serval:BIB_D3B4F544BDF7
PMID
Open Access
Oui
Date de création
2023-06-29T13:03:05.774Z
Date de création dans IRIS
2025-05-21T01:59:52Z
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Nom
37380369_BIB_D3B4F544BDF7.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by-nc/4.0
Taille
1.43 MB
Format
Adobe PDF
PID Serval
serval:BIB_D3B4F544BDF7.P001
URN
urn:nbn:ch:serval-BIB_D3B4F544BDF79
Somme de contrôle
(MD5):9606f1c639ec4533f2da68ba5c5d0500