帕博利珠单抗与挽救性化疗用于表皮生长因子受体T790M阳性、程序性死亡受体配体1高表达的非小细胞肺癌治疗
Pembrolizumab and salvage chemotherapy in EGFR T790M-positive non-small-cell lung cancer with high PD-L1 expression.
作者信息
Tozuka Takehiro, Seike Masahiro, Minegishi Yuji, Kitagawa Shingo, Kato Tomomi, Takano Natsuki, Hisakane Kakeru, Takahashi Satoshi, Kobayashi Kenichi, Kashiwada Takeru, Sugano Teppei, Takeuchi Susumu, Kunugi Shinobu, Noro Rintaro, Saito Yoshinobu, Kubota Kaoru, Gemma Akihiko
机构信息
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan,
Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
出版信息
Onco Targets Ther. 2018 Sep 7;11:5601-5605. doi: 10.2147/OTT.S168598. eCollection 2018.
Immuno-checkpoint inhibitors (ICI) have become an effective treatment option for non-small-cell lung cancer patients. However, ICI therapy was reported to be less effective in patients with epidermal growth factor receptor (EGFR) mutations than in those with wild-type EGFR. We report here that an non-small-cell lung cancer patient with the EGFR mutant T790M showed a programmed cell death ligand 1 (PD-L1) expression level that increased from <25% to >90% after eighth-line osimertinib therapy. He was treated with pembrolizumab as a ninth-line treatment, and attained stable disease. After the pembrolizumab therapy, he was treated with gemcitabine, which produced a good response despite being the 10th-line treatment. We should consider administering ICI and chemotherapy even to EGFR mutant patients after failure of EGFR tyrosine kinase inhibitor, especially in cases with high PD-LI expression.
免疫检查点抑制剂（ICI）已成为非小细胞肺癌患者的一种有效治疗选择。然而，据报道，ICI疗法对表皮生长因子受体（EGFR）突变患者的疗效低于野生型EGFR患者。我们在此报告，一名患有EGFR突变T790M的非小细胞肺癌患者在接受第八线奥希替尼治疗后，程序性细胞死亡配体1（PD-L1）表达水平从<25%增加到>90%。他接受派姆单抗作为第九线治疗，并达到疾病稳定。在派姆单抗治疗后，他接受了吉西他滨治疗，尽管这是第十线治疗，但仍产生了良好的反应。即使在EGFR酪氨酸激酶抑制剂治疗失败后，我们也应考虑对EGFR突变患者使用ICI和化疗，尤其是在PD-LI高表达的情况下。
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