Hearon Bernard F, Redelman Kyle N, Elhomsy Georges C, Moore Dennis F
Department of Orthopaedics, University of Kansas School of Medicine, Wichita, Kansas, USA.
Kansas Imaging Consultants, Wichita, Kansas, USA.
Case Rep Oncol. 2020 Dec 14;13(3):1483-1489. doi: 10.1159/000512013. eCollection 2020 Sep-Dec.
The lead author with clinical stage I malignant pleural mesothelioma, epithelioid type, highly programmed cell death ligand 1 (PD-L1) positive, and BAP1 negative, experienced a prompt and exceptionally favorable response to pembrolizumab monotherapy. After cessation of treatment due to immune-related endocrinopathies, complete metabolic response on interim PET/CT scan was achieved. Two years after initial diagnosis, unifocal tumor reactivation was addressed with successful pembrolizumab monotherapy rechallenge. Immunotherapy, typically not used as frontline treatment for malignant pleural mesothelioma, may provide an effective and durable response for some patients. Based on this single case study, epithelioid type tumors with strongly positive PD-L1 and BAP1-negative immunohistochemical markers may be well suited for treatment with immune checkpoint inhibitors such as pembrolizumab.
第一作者患有临床I期恶性胸膜间皮瘤，上皮样型，程序性细胞死亡配体1（PD-L1）高度阳性，BAP1阴性，接受帕博利珠单抗单药治疗后迅速出现了极为良好的反应。因免疫相关内分泌病停止治疗后，中期PET/CT扫描显示达到了完全代谢缓解。初始诊断两年后，单灶性肿瘤复发，再次使用帕博利珠单抗单药治疗获得成功。免疫疗法通常不作为恶性胸膜间皮瘤的一线治疗方法，但对某些患者可能提供有效且持久的反应。基于此单病例研究，PD-L1强阳性且BAP1免疫组化标记物阴性的上皮样型肿瘤可能非常适合使用帕博利珠单抗等免疫检查点抑制剂进行治疗。
