Keohane David, Fitzgerald Gerald Paul
Department of Oncology, Mercy University Hospital, Cork, Ireland.
Department of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
BMJ Case Rep. 2018 Sep 1;2018:bcr-2018-224784. doi: 10.1136/bcr-2018-224784.
This case demonstrates the effectiveness and ongoing potential of novel lung cancer therapies, specifically immunotherapy agents such as nivolumab, a T-cell programmed death 1 (PD-1) receptor inhibitor. In this case study, our patient had a significant burden of disease with nodal involvement above and below the diaphragm at the time of diagnosis. They were commenced on standard of care therapy: cisplatin and pemetrexed. Despite five cycles of treatment with these agents, their disease progressed significantly with the development of brain metastasis. The patient was switched to a novel immunotherapy agent, nivolumab, and had a complete response to it. Currently, there is no active disease-the lymph nodes have all regressed, the brain metastases have disappeared (with the help of stereotactic surgery) and no further metastases have developed. The patient is tolerating the treatment well and has had no significant adverse reactions to the immunotherapy agent.
本病例展示了新型肺癌治疗方法的有效性及持续潜力，特别是免疫治疗药物，如纳武单抗，一种T细胞程序性死亡1（PD-1）受体抑制剂。在本病例研究中，我们的患者在诊断时疾病负担较重，膈上下均有淋巴结受累。他们开始接受标准治疗方案：顺铂和培美曲塞。尽管使用这些药物进行了五个周期的治疗，但随着脑转移的出现，他们的疾病仍显著进展。患者转而使用新型免疫治疗药物纳武单抗，并对此产生了完全缓解。目前，没有活动性疾病——淋巴结全部消退，脑转移灶已消失（在立体定向手术的帮助下），且未出现进一步转移。患者对治疗耐受性良好，对免疫治疗药物未出现明显不良反应。
