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化疗联合阿特珠单抗治疗一名接受血液透析的小细胞肺癌患者:病例报告及文献综述

Chemotherapy plus atezolizumab for a patient with small cell lung cancer undergoing haemodialysis: a case report and review of literature.

作者信息

Imaji Mihoko, Fujimoto Daichi, Kato Mai, Tanaka Masanori, Furuta Katsuyuki, Yamamoto Nobuyuki

机构信息

Internal Medicine III Wakayama Medical University Wakayama Japan.

出版信息

Respirol Case Rep. 2021 Mar 25;9(5):e00741. doi: 10.1002/rcr2.741. eCollection 2021 May.

Abstract

Little is known about the safety of chemotherapy plus atezolizumab for patients with extensive-stage small cell lung cancer (ES-SCLC) undergoing haemodialysis (HD). An 80-year-old male received carboplatin [area under the concentration-time curve (AUC) = 5 on day 1], etoposide (40 mg/m on days 1, 2, and 3), and atezolizumab (1200 mg/body on day 1) as the first-line therapy for ES-SCLC. He was undergoing HD thrice a week for seven years. HD was provided 16 h after carboplatin administration. During the first cycle, grade 4 neutropenia (neutrophil count: 74/μL) and leukopenia (white blood cell count: 680/μL) occurred. Therefore, chemotherapy was administered with a reduced dose of carboplatin (AUC = 4) and etoposide (30 mg/m) from the second to fourth cycles. After four cycles, no severe non-haematological adverse events occurred, showing a remarkable response. We conclude that the carboplatin, etoposide, and atezolizumab combination can be safely administered to cancer patients undergoing HD.

摘要

对于接受血液透析(HD)的广泛期小细胞肺癌(ES-SCLC)患者,化疗联合阿特珠单抗的安全性知之甚少。一名80岁男性接受了卡铂(第1天浓度-时间曲线下面积[AUC]=5)、依托泊苷(第1、2、3天40mg/m)和阿特珠单抗(第1天1200mg/体)作为ES-SCLC的一线治疗。他每周进行3次血液透析,已持续7年。在卡铂给药16小时后进行血液透析。在第一个周期中,出现了4级中性粒细胞减少(中性粒细胞计数:74/μL)和白细胞减少(白细胞计数:680/μL)。因此,从第二个周期到第四个周期,化疗采用降低剂量的卡铂(AUC = 4)和依托泊苷(30mg/m)。四个周期后,未发生严重的非血液学不良事件,显示出显著疗效。我们得出结论,卡铂、依托泊苷和阿特珠单抗联合用药可安全地用于接受血液透析的癌症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4307/7991827/8db914d75404/RCR2-9-e00741-g001.jpg

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