HPV 相关小细胞癌患者对联合免疫检查点抑制剂治疗有良好反应：一例报告
A robust response to combination immune checkpoint inhibitor therapy in HPV-related small cell cancer: a case report.
机构信息
Department of Oncology, Johns Hopkins University School of Medicine, 1650 Orleans St, CRB1 Rm#186, Baltimore, MD, 21287, USA.
Department of Pathology, Johns Hopkins University School of Medicine, 410 N Broadway, Rm#2249, Baltimore, MD, 21287, USA.
出版信息
J Immunother Cancer. 2018 May 9;6(1):33. doi: 10.1186/s40425-018-0348-4.
BACKGROUND
Human papillomavirus-related small cell carcinoma of the head and neck is an extremely rare, aggressive subtype with poor outcomes. Therapeutic options are limited and are largely adopted from small cell lung cancer treatment paradigms.
CASE PRESENTATION
This report describes a 69-year old male who was diagnosed of HPV-related oropharyngeal cancer with mixed small cell and squamous cell pathology which was clinically aggressive and progressed through multimodal platinum-based therapies. Upon manifestation of worsening metastatic disease, the patient was initiated on a combination of ipilimumab and nivolumab. Within 2 months of starting immunotherapy, a robust partial response was observed. During the treatment course, the patient developed immune-related adverse effects including new diabetes mellitus, colitis, and hypothyroidism. The disease-specific survival was 26 months.
CONCLUSION
Combination immunotherapy may be an attractive option for HPV-related small cell head and neck cancers resistant to other treatment modalities and thus warrants further evaluation.
背景
人乳头瘤病毒相关的头颈部小细胞癌是一种极其罕见且侵袭性强的亚型，预后较差。治疗选择有限，主要采用小细胞肺癌的治疗模式。
病例介绍
本报告描述了一名 69 岁男性，被诊断为 HPV 相关的口咽癌，其病理表现为混合性小细胞和鳞状细胞，具有明显的侵袭性，且通过多种模式的铂类药物治疗进展。在转移性疾病恶化表现出来后，患者开始接受伊匹单抗和纳武利尤单抗联合治疗。免疫治疗开始后 2 个月，观察到明显的部分缓解。在治疗过程中，患者出现了免疫相关的不良反应，包括新发糖尿病、结肠炎和甲状腺功能减退。疾病特异性生存时间为 26 个月。
结论
联合免疫疗法可能是对其他治疗方法耐药的 HPV 相关小细胞头颈部癌的一种有吸引力的选择，因此值得进一步评估。
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