安罗替尼与信迪利单抗联用致结肠炎

Colitis induced by combination use of anlotinib and sintilimab

1例69岁男性患者因腹膜后肉瘤接受安罗替尼胶囊(12 mg口服、1次/d,服用14 d,停药7 d)和信迪利单抗注射液(200 mg静脉滴注、第1天)方案治疗,21 d为1个周期。患者既往无腹泻病史,肠镜检查未见明显异常。治疗18 d后患者出现腹泻,考虑与安罗替尼胶囊联合信迪利单抗注射液有关,停止使用上述2药,予激素和对症治疗。6 d后患者腹泻好转,肠镜检查提示结肠炎。考虑患者原发疾病,按原剂量口服安罗替尼胶囊单药治疗。2 d后患者再次出现腹泻且较前加重,再次停用安罗替尼胶囊。予激素冲击、抗感染及对症治疗,14 d后患者腹泻好转。

A 69‑year‑old male patient with retroperitoneal sarcoma received anlotinib capsules(12 mg orally once daily for 14 days,interruption for 7 days)and sintilimab injection(IV infusion of 200 mg on the first day)and 21 days was a cycle.He had no history of diarrhea and previous enteroscopy showed no obvious abnormality.So the diarrhea,which occurred after 18 days of treatments,was considered to be related to the combination use of anlotinib capsules and sintilimab injection.Above 2 drugs were stopped and hormone and symptomatic treatments were given.Six days later,the patient′s diarrhea was improved,and enteroscopy showed colitis.Considering the primary disease,the patient was treated with oral anlotinib capsule monotherapy with the same dose as before.Two days later,the patient had diarrhea again,which was more serious than before,and the anlotinib capsules were stopped again.After 14 days of hormone shock therapy,anti‑infection therapy,and symptomatic treatments,the patient′s diarrhea was improved.