• Rev Med Interne · Jul 2021

    Case Reports

    [Aggressive tumor progression during immunosuppressive therapy with abatacept].

    • J Lapoirie, F Lefort, E Mériglier, C Rivoisy, A Contis, M A Vandenhende, and F Bonnet.
    • Service de médecine interne et maladies infectieuses, hôpital Saint-André, CHU de Bordeaux, 33000 Bordeaux, France. Electronic address: joelle.lapoirie@chu-bordeaux.fr.
    • Rev Med Interne. 2021 Jul 1; 42 (7): 505-508.

    IntroductionCo-stimulatory molecule cytotoxic T-lymphocyte antigen-4 (CTLA-4) inhibits T-cell activation. Clinically, CTLA-4 has been targeted in opposite ways: its blockade enhances antitumor immunity in the field of oncology, whereas CTLA-4 agonists such as abatacept are used for the treatment of immuno-inflammatory diseases as rheumatoid arthritis (RA).ObservationWe herein report the case of a 69-year-old man with a history of severe RA successfully treated with abatacept, who showed unusually rapid progression of undifferentiated multi-metastatic carcinoma.DiscussionAlthough no significant increase in malignancy has been reported in abatacept-treated patients, several case reports have documented the possible association with the acceleration of the progression of malignancy. Here, abatacept may have altered immune surveillance and hence allowed tumor growth.Copyright © 2021 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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