Department of Medicine A: Hematology, Hemostaseology, Oncology and Pneumology, University Hospital Muenster, Muenster, Germany.
Gerhard-Domagk-Institute of Pathology, University Hospital Muenster, Muenster, Germany.
Thorac Cancer. 2021 Feb;12(4):553-556. doi: 10.1111/1759-7714.13793. Epub 2020 Dec 27.
About 40% of non-small lung cancer (NSCLC) patients have metastatic disease at the time of diagnosis. However, metastatic NSCLC in the biliary duct system is extremely rare. A high proportion of patients with acute liver failure due to advanced NSCLC do not receive any treatment due to organ dysfunction or poor performance status. Here, we report a case of successful treatment with chemoimmunotherapy in a young woman with obstructive jaundice and acute hepatic failure due to multiple intrahepatic bile duct metastases. KEY POINTS: Significant findings of the study Chemotherapy in NSCLC patients with liver failure is a therapeutic challenge. Acute hepatic failure are often exclusion criteria for therapy of NSCLC. Some reports showed a benefit of ICIs plus chemotherapy for NSCLC with liver metastases. What this study adds Combination of ICIs and chemotherapy is effective and safe in critically ill patients with lung cancer and impaired liver function.
约 40%的非小细胞肺癌（NSCLC）患者在诊断时已发生转移性疾病。然而，胆管系统中的转移性 NSCLC 极为罕见。由于晚期 NSCLC 导致的急性肝功能衰竭，相当一部分患者因器官功能障碍或一般状况不佳而未接受任何治疗。在此，我们报告了一例年轻女性因多发肝内胆管转移导致阻塞性黄疸和急性肝衰竭，经化疗免疫治疗成功治疗的病例。
研究的重要发现：
对于肝功能衰竭的 NSCLC 患者，化疗是一种治疗挑战。
急性肝功能衰竭通常是 NSCLC 治疗的排除标准。
一些报告显示，ICI 联合化疗对肝转移的 NSCLC 有益。
本研究的新增内容：
ICI 联合化疗对患有肺癌和肝功能受损的重症患者是有效且安全的。
