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肺腺癌伴症状性脑转移对纳武单抗加口服高剂量皮质类固醇的部分缓解:病例报告

Partial response of pulmonary adenocarcinoma with symptomatic brain metastasis to nivolumab plus high-dose oral corticosteroid: a case report.

作者信息

Pluchart Hélène, Pinsolle Julian, Cohen Julien, Ferretti Gilbert R, Bedouch Pierrick, Giaj Levra Matteo, Toffart Anne-Claire, Moro-Sibilot Denis

机构信息

Pôle pharmacie, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France.

Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, France.

出版信息

J Med Case Rep. 2017 Jul 6;11(1):183. doi: 10.1186/s13256-017-1334-z.

Abstract

BACKGROUND

Nivolumab, a monoclonal antibody targeting the programmed death-1 receptor, is indicated in locally advanced or metastatic non-small cell lung cancer, with progression after platinum-based chemotherapy. Up-to-now, few data are available concerning brain activity of this treatment and concomitant use of corticosteroids.

CASE PRESENTATION

A 64-year-old caucasian man with a pulmonary adenocarcinoma associated with brain metastases received four courses of nivolumab in concomitance with a high dose of corticosteroids for his neurologic symptoms. He experienced a partial response in his brain and chest with an improvement in his general condition. Nivolumab was effective in shrinking symptomatic brain metastases, and metastases at other sites, in a patient with non-small cell lung cancer and first-line chemotherapy failure. The effect of nivolumab was obtained despite concomitant high-dose corticosteroid therapy. Combined nivolumab and high-dose corticosteroid therapy did not induce unexpected adverse events.

CONCLUSION

Nivolumab and concomitant high-dose corticosteroid therapy was found to be efficient and well tolerated.

摘要

背景

纳武单抗是一种靶向程序性死亡-1受体的单克隆抗体,适用于局部晚期或转移性非小细胞肺癌,且在铂类化疗后出现进展的患者。到目前为止,关于这种治疗的脑活动以及同时使用皮质类固醇的数据很少。

病例报告

一名64岁的白人男性,患有伴有脑转移的肺腺癌,因神经系统症状接受了四个疗程的纳武单抗治疗,并同时使用了高剂量的皮质类固醇。他的脑部和胸部出现部分缓解,全身状况有所改善。纳武单抗对一名非小细胞肺癌且一线化疗失败的患者的有症状脑转移和其他部位转移灶缩小有效。尽管同时进行了高剂量皮质类固醇治疗,但仍获得了纳武单抗的疗效。纳武单抗与高剂量皮质类固醇联合治疗未引发意外不良事件。

结论

发现纳武单抗与高剂量皮质类固醇联合治疗有效且耐受性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7f3/5499003/acd89888b0a3/13256_2017_1334_Fig1_HTML.jpg

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