复发性胶质母细胞瘤患者接受分子靶向治疗后的 8 年生存：病例报告。
Eight-year survival of a recurrent glioblastoma patient treated with molecularly tailored therapy: a case report.
机构信息
Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Department of Pathology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
出版信息
Acta Neurochir (Wien). 2018 Dec;160(12):2387-2391. doi: 10.1007/s00701-018-3697-3. Epub 2018 Oct 11.
Treatment options for recurrent glioblastoma are scarce; targeted therapy trials were disappointing, probably due to enrollment of patients without molecular selection. We treated with bevacizumab and erlotinib a 66-year-old male suffering from recurrent glioblastoma, IDH-wildtype and MGMT unmethylated, after three neurosurgeries. Treatment was tailored on molecular profile of recurrent tumor-namely, EGFRvIII positivity, VEGF overexpression, normal PTEN, low total VEGF and VEGF-121 mRNA-and resulted in complete, exceptionally durable response (51-month progression-free survival). Notably, histology of further recurrence after therapy was reminiscent of sarcoma. We suggest a thorough molecular screening for personalization of targeted therapy in recurrent glioblastoma.
复发性胶质母细胞瘤的治疗选择有限；靶向治疗试验令人失望，这可能是由于未进行分子选择就招募了患者。我们对一名 66 岁的男性患者进行了贝伐珠单抗和厄洛替尼治疗，该患者患有复发性胶质母细胞瘤，IDH 野生型，MGMT 未甲基化，已接受了 3 次神经外科手术。治疗方案根据复发性肿瘤的分子特征进行了定制，即 EGFRvIII 阳性、VEGF 过表达、PTEN 正常、总 VEGF 和 VEGF-121 mRNA 水平低，并产生了完全、异常持久的反应（51 个月无进展生存期）。值得注意的是，治疗后进一步复发的组织学表现类似于肉瘤。我们建议对复发性胶质母细胞瘤进行全面的分子筛查，以实现靶向治疗的个体化。
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