Daido Wakako, Yamasaki Masahiro, Saito Naomi, Ishiyama Sayaka, Deguchi Naoko, Taniwaki Masaya, Daga Haruko, Ohashi Nobuyuki
Dept. of Respiratory Disease, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital.
Gan To Kagaku Ryoho. 2017 Jan;44(1):59-62.
The anti-programmed death-1 antibody nivolumab is an important treatment option for non-small-cell lung carcinoma.However, its effectiveness for large-cell neuroendocrine carcinomas(LCNEC)is still controversial.Here, we report 2 cases of LCNECs that responded to nivolumab.Case 1: A 62-year-old man received chemotherapy and radiotherapy for stage III A lung adenocarcinoma.One year later, another lung lesion was observed and diagnosed as LCNEC using surgical lung biopsy.Although he subsequently received some chemotherapy regimens, the patient developed new brain metastasis, expanded mediastinal lesion, and increased levels of the tumor marker pro-gastrin releasing peptide(ProGRP).We started nivolumab as the sixth-line treatment.In response, ProGRP levels significantly decreased and the mediastinal lesion became smaller.Case 2: A 55-year-old man was diagnosed with stage III A LCNEC and received chemotherapy and radiotherapy.The primary lesion was controlled; however, lung metastases developed and chemotherapy was unable to control them.We provided treatment with nivolumab as the third-line therapy.The tumor marker ProGRP decreased and the lung metastases became smaller.
Nivolumab can be a valuable treatment option for LCNEC.
抗程序性死亡-1抗体纳武单抗是治疗非小细胞肺癌的重要选择。然而，其对大细胞神经内分泌癌（LCNEC）的疗效仍存在争议。在此，我们报告2例对纳武单抗有反应的LCNEC病例。病例1：一名62岁男性因ⅢA期肺腺癌接受了化疗和放疗。一年后，观察到肺部出现另一个病变，经手术肺活检诊断为LCNEC。尽管他随后接受了一些化疗方案，但患者出现了新的脑转移、纵隔病变扩大以及肿瘤标志物胃泌素释放肽前体（ProGRP）水平升高。我们开始将纳武单抗作为第六线治疗。作为反应，ProGRP水平显著下降，纵隔病变变小。病例2：一名55岁男性被诊断为ⅢA期LCNEC，并接受了化疗和放疗。原发病变得到控制；然而，出现了肺转移，化疗无法控制。我们将纳武单抗作为三线治疗提供治疗。肿瘤标志物ProGRP下降，肺转移变小。
纳武单抗可能是LCNEC的一种有价值的治疗选择。
