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纳武单抗联合化疗后手术有效治疗非小细胞肺癌:一例报告及文献简要综述

Effective Treatment of NSCLC with Surgery After Nivolumab Combined with Chemotherapy: A Case Report and Brief Review of the Literature.

作者信息

Zhao Liangchen, Li Luzhen, Chen Ting, Fang Cantu

机构信息

Department of Oncology, Zhongshan Hospital Affiliated to Guangzhou TCM University, Zhongshan, People's Republic of China.

出版信息

Onco Targets Ther. 2020 Dec 30;13:13307-13313. doi: 10.2147/OTT.S266155. eCollection 2020.

Abstract

INTRODUCTION

Immuno checkpoint inhibitors (ICIs) including anti-PD-L1 antibody have shown certain therapeutic effects on various cancer types. Here, we reported a case of the patient with resectable non-small cell lung cancer (NSCLC) showing a complete response to nivolumab combined with chemotherapy.

PATIENT INFORMATION

A 66-year-old male was diagnosed with stage IIIA large cell lung cancer, cT2N2M0, who was considered impossible to have a tumor resection due to his right hilar node enlargement. The diameter of the neoplasms was 22mm, and the patient wanted to get the chance of surgery. Light of all, surgery was the only radical treatment option and therefore planned.

INTERVENTIONS

After administering 2 cycles of nivolumab combined with paclitaxel and cisplatin, the second chest computed tomography (CT) after the first scanning revealed the tumor apparent shrinking and vascular compression was disappeared than before. We performed a right upper lobectomy and mediastinal lymph node dissection. Pathologically, we confirmed no large cell lung cancer cells in the resected lung specimen.

OUTCOMES

The follow-up showing that patient remains alive without recurrence to these days.

CONCLUSION

This case report may provide a clue to the future development of induction therapy using nivolumab and surgery. The combined treatment of nivolumab and chemotherapy is likely to be considered as an optional management of resectable NSCLC.

摘要

引言

包括抗程序性死亡受体配体1(PD-L1)抗体在内的免疫检查点抑制剂已在多种癌症类型中显示出一定的治疗效果。在此,我们报告了1例可切除的非小细胞肺癌(NSCLC)患者,其对纳武单抗联合化疗表现出完全缓解。

患者信息

一名66岁男性被诊断为ⅢA期大细胞肺癌,cT2N2M0,由于其右肺门淋巴结肿大,被认为无法进行肿瘤切除。肿瘤直径为22mm,患者希望获得手术机会。考虑到所有因素,手术是唯一的根治性治疗选择,因此计划进行手术。

干预措施

在给予2个周期的纳武单抗联合紫杉醇和顺铂治疗后,首次扫描后的第二次胸部计算机断层扫描(CT)显示肿瘤明显缩小,血管压迫较之前消失。我们进行了右上叶切除术和纵隔淋巴结清扫术。病理检查证实,切除的肺标本中没有大细胞肺癌细胞。

结果

随访显示患者至今仍存活且无复发。

结论

本病例报告可能为未来使用纳武单抗和手术进行诱导治疗的发展提供线索。纳武单抗和化疗的联合治疗可能被视为可切除NSCLC的一种可选治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b88a/7779284/93cf0b208af4/OTT-13-13307-g0001.jpg

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