Oncologia Medica, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni - 15, Bologna, Italy.
Radiology Department, Azienda Ospedaliero-Universitaria di Bologna, via Albertoni - 15, Bologna, Italy.
J Immunother Cancer. 2020 Oct;8(2). doi: 10.1136/jitc-2019-000502.
Non-small cell lung cancer (NSCLC) can be associated with pulmonary cystic airspaces (pCAs). pCAs are radiologically classified into four types based on whether the nodule or mass extrudes the wall of the pCAs. In most cases, response evaluation of these lesions by Response Evaluation Criteria in Solid Tumors (RECIST) V.1.1 is challenging. Based on the observation of a case of morphological evolution of pCAs associated with NSCLC in a patient receiving immune checkpoint inhibitor (ICI), we reviewed retrospectively imaging scans of 92 consecutive advanced patients with NSCLC treated at our institution. Overall, three cases of pCAs associated with NSCLC obtained a remarkable change following ICI. Of note, these changes were not always seen in the context of a clear radiological objective response. The morphological changes observed may reflect a novel pattern of response to immunotherapy agents that clinicians should be aware of. This pattern of response, not reported before, warrants further investigation and, if confirmed, we believe that it should be considered in future version of immune RECIST.
非小细胞肺癌（NSCLC）可伴有肺囊性气腔（pCAs）。pCAs 根据结节或肿块是否突出 pCAs 的壁在影像学上分为四型。在大多数情况下，通过实体瘤反应评估标准（RECIST）V.1.1 评估这些病变的反应具有挑战性。基于对接受免疫检查点抑制剂（ICI）治疗的患者 NSCLC 相关 pCA 形态演变的观察，我们回顾性分析了我院 92 例连续接受治疗的晚期 NSCLC 患者的影像学扫描。总体而言，3 例 NSCLC 相关 pCA 在接受 ICI 治疗后获得了显著变化。值得注意的是，这些变化并不总是在明确的影像学客观反应的背景下出现。观察到的形态学变化可能反映了免疫治疗药物的一种新的反应模式，临床医生应注意这一点。这种反应模式以前没有报道过，需要进一步研究，如果得到证实，我们认为应该在未来的免疫 RECIST 版本中考虑。
