A patient with HER2-positive early breast cancer (BC) developed dermatomyositis (DM), which disappeared after the first administration of adjuvant trastuzumab. No HER2 overexpression/amplification was observed in DM skin biopsies. Both BC and skin immune infiltrates were composed mostly of CD3+ T-lymphocytes. Interestingly, tumor-infiltrating lymphocytes expressed PD-1, which was negligible in skin-infiltrating lymphocytes, while both BC cells and keratinocytes were PD-L1-positive. High serum levels of endogenous anti-HER2 antibodies were detected, confirming the induction of a HER2-specific adaptive immune response. It may be argued that HER2-specific T-lymphocytes cross-reacted with one or more unknown skin antigens, causing DM. Trastuzumab may have silenced skin cross-reaction by eliminating any residual HER2-positive micrometastatic disease and, thus, inducing DM remission.

Clinico-Immunological Profile of a 67-Year-Old Woman Affected by HER2-Positive Breast Cancer and Autoimmune Dermatomyositis / Pellegrino, B.; Mazzaschi, G.; Madeddu, D.; Mori, C.; Lagrasta, C. A. M.; Missale, G.; Quaini, F.; Musolino, A.. - In: FRONTIERS IN ONCOLOGY. - ISSN 2234-943X. - 10(2020), p. 192. [10.3389/fonc.2020.00192]

Clinico-Immunological Profile of a 67-Year-Old Woman Affected by HER2-Positive Breast Cancer and Autoimmune Dermatomyositis

Pellegrino B.;Mazzaschi G.;Madeddu D.;Lagrasta C. A. M.;Missale G.;Quaini F.;Musolino A.
Conceptualization
2020

Abstract

A patient with HER2-positive early breast cancer (BC) developed dermatomyositis (DM), which disappeared after the first administration of adjuvant trastuzumab. No HER2 overexpression/amplification was observed in DM skin biopsies. Both BC and skin immune infiltrates were composed mostly of CD3+ T-lymphocytes. Interestingly, tumor-infiltrating lymphocytes expressed PD-1, which was negligible in skin-infiltrating lymphocytes, while both BC cells and keratinocytes were PD-L1-positive. High serum levels of endogenous anti-HER2 antibodies were detected, confirming the induction of a HER2-specific adaptive immune response. It may be argued that HER2-specific T-lymphocytes cross-reacted with one or more unknown skin antigens, causing DM. Trastuzumab may have silenced skin cross-reaction by eliminating any residual HER2-positive micrometastatic disease and, thus, inducing DM remission.
Clinico-Immunological Profile of a 67-Year-Old Woman Affected by HER2-Positive Breast Cancer and Autoimmune Dermatomyositis / Pellegrino, B.; Mazzaschi, G.; Madeddu, D.; Mori, C.; Lagrasta, C. A. M.; Missale, G.; Quaini, F.; Musolino, A.. - In: FRONTIERS IN ONCOLOGY. - ISSN 2234-943X. - 10(2020), p. 192. [10.3389/fonc.2020.00192]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2875164
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