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度伐利尤单抗致重度皮肤毒性反应1例的药学监护 Δ
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季留连 ，覃正碧 ，柳鹏程 ，邓晓文 ，刘丽丽 ，姚立娟 ，刘婷婷 ，顾萍辰 [1.盐城市第二人民医院肿瘤内科，
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江苏 盐城 224000；2.湖北民族大学医学部人文医学教研室，湖北 恩施 445000；3.中国药科大学国际医药商
学院，南京 211198；4.盐城市食品药品监督检验中心（药品不良反应监测中心），江苏 盐城 224000；5.盐城市
第二人民医院药学科，江苏 盐城 224000]
中图分类号 R979.1；R969.3 文献标志码 A 文章编号 1001-0408（2026）01-0088-04
DOI 10.6039/j.issn.1001-0408.2026.01.16
摘 要 目的 为正确识别、应对度伐利尤单抗致免疫相关皮肤毒性反应（irCAEs）及保障临床用药安全提供参考。方法 临床药
师参与度伐利尤单抗致1例胆囊癌患者发生irCAEs的诊治过程，通过系统查阅患者既往史、用药史，协助医生判断该不良反应与
所用药物的关联性；同时，临床药师对该不良反应进行分级评估，提出停用度伐利尤单抗、调整糖皮质激素用法等建议，协助医生
重启免疫治疗，并开展用药宣教等药学监护。结果 该患者irCAEs的发生“很可能”与度伐利尤单抗相关，且为重度。医生采纳临
床药师意见，患者经对症治疗后皮肤症状好转，带药出院。待患者糖皮质激素治疗结束后，医生以替雷利珠单抗重启免疫治疗，患
者未再发生相关不良反应。结论 度伐利尤单抗可导致重度皮肤斑丘疹等irCAEs。临床应及时寻找并停用可疑药物，立即采取
有效的对症治疗措施并积极重启免疫治疗，以保证患者治疗的延续性和安全性。
关键词 度伐利尤单抗；免疫相关皮肤毒性反应；药学监护；免疫检查点抑制剂
Pharmaceutical care for a case of severe dermal toxicity induced by durvalumab
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JI Liulian ，QIN Zhengbi ，LIU Pengcheng ，DENG Xiaowen ，LIU Lili ，YAO Lijuan ，LIU Tingting ，
GU Pingchen [1. Dept. of Oncology， Yancheng Second People’s Hospital， Jiangsu Yancheng 224000， China；
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2. Dept. of Humanities and Medical Ethics， School of Medicine， Hubei Minzu University， Hubei Enshi
445000， China；3. School of International Pharmaceutical Business， China Pharmaceutical University， Nanjing
211198， China；4. Yancheng Food and Drug Inspection Center （Adverse Drug Reaction Monitoring Center），
Jiangsu Yancheng 224000， China；5. Dept. of Pharmacy， Yancheng Second People’s Hospital， Jiangsu Yancheng
224000， China]
ABSTRACT OBJECTIVE To provide references for the accurate identification and management of immune-related cutaneous
adverse events （irCAEs） caused by durvalumab， and ensuring safe clinical drug use. METHODS Clinical pharmacists participated
in the diagnosis and treatment process of a patient with gallbladder cancer who developed irCAEs caused by durvalumab. The
clinical pharmacists systematically reviewed the patient’s past medical history and medication history， and assisted physicians in
assessing the association between adverse drug reactions and administered drugs. Meanwhile， the clinical pharmacists conducted a
graded assessment of the adverse reaction， proposed recommendations such as discontinuing durvalumab and adjusting the
administration regimen of glucocorticoids， assisted physicians in restarting immunotherapy， and carried out medication education
and other pharmaceutical care. RESULTS The occurrence of irCAEs in this patient was “highly likely” related to durvalumab and
was classified as severe. The physicians adopted the clinical pharmacist’s opinion， and after symptomatic treatment， the patient’s
skin symptoms improved， and discharged with medication. After the completion of glucocorticoid therapy for the patient， the
physician restarted immunotherapy with tislelizumab， and no related adverse reactions occurred again in the patient.
CONCLUSIONS Durvalumab can cause irCAEs such as severe skin maculopapular rash. In clinical practice， it is crucial to
promptly identify and discontinue suspicious drugs， immediately implement effective symptomatic treatment measures， and actively
resume immunotherapy to ensure the continuity and safety of the patient’s treatment.
KEYWORDS durvalumab； immune-related cutaneous adverse events； pharmaceutical care； immune checkpoint inhibitors
度伐利尤单抗（durvalumab）是英国 AstraZeneca 公 司研发的免疫检查点抑制剂（immune checkpoint inhibi‐
tors，ICIs），是抗程序性死亡受体配体 1（programmed
Δ 基金项目 国家自然科学基金项目（No.72474225） death-ligand 1，PD-L1）的人源化单克隆抗体，可通过阻
＊第一作者 副主任医师，硕士。研究方向：肿瘤内科的整合治疗。
断 PD-L1 与活化 T 细胞表面的程序性死亡受体 1（pro‐
E-mail：jll1582005@163.com
grammed death-1，PD-1）的结合来增强 T 细胞对肿瘤细
# 通信作者 副主任药师。研究方向：药品不良反应监测。
E-mail：603859696@163.com 胞的杀伤力 [1―2] 。2022年9月2日，美国FDA批准了度伐
· 88 · China Pharmacy 2026 Vol. 37 No. 1 中国药房 2026年第37卷第1期
