Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan.
Department of Pathology, Sasebo City General Hospital, Nagasaki, Japan.
Thorac Cancer. 2018 Jan;9(1):175-180. doi: 10.1111/1759-7714.12543. Epub 2017 Oct 24.
Promising outcomes of salvage chemotherapy after nivolumab therapy have been reported; however, little is known about the detailed clinical and immunologic features in lung cancer patients in whom nivolumab is unsuccessful. We report two cases of nivolumab-refractory lung cancer, in which chemotherapy resulted in rapid regression of the lung cancer. Upon initial diagnosis, the biopsy specimens showed PD-ligand 1 (PD-L1)-expressing cancer cells, accompanied by tumor-infiltrating lymphocytes with a favorable CD8/CD4 ratio. Immunosuppressive regulatory T cells and cells positive for TIM-3 were also observed. Physicians should take caution in treating lung cancer patients after progression on nivolumab. Further studies with a large cohort are warranted to identify the patients that may benefit from salvage chemotherapy.
已经有报道称纳武利尤单抗治疗后挽救性化疗有良好的效果；然而，对于纳武利尤单抗治疗无效的肺癌患者的详细临床和免疫特征，我们知之甚少。我们报告了两例纳武利尤单抗难治性肺癌病例，这些患者接受化疗后肺癌迅速消退。在初始诊断时，活检标本显示 PD-配体 1（PD-L1）表达的癌细胞，伴有具有有利 CD8/CD4 比值的肿瘤浸润淋巴细胞。还观察到免疫抑制调节 T 细胞和 TIM-3 阳性细胞。医生在纳武利尤单抗治疗进展后治疗肺癌患者时应谨慎。需要进一步进行大样本研究，以确定可能从挽救性化疗中获益的患者。
