Ni Junjun, Yang Liangwei, Zhu Huangkai, Chu Minghui, Zhang Chenxu, Zhao Weidi, Yang Minglei, Xu Xiang, Zheng Enkuo, Jiang Xu, Li Rui, Zhao Guofang
Department of Cardiothoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), Ningbo, China; Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), Ningbo, China.
Clinical Department, Medical School of Ningbo University, Ningbo, China.
Ann Palliat Med. 2021 Apr;10(4):4999-5009. doi: 10.21037/apm-21-860.
Lung cancer is a malignancy with the highest morbidity and mortality in the world. Radiotherapy, chemotherapy, targeted therapy, and immunotherapy have been widely used to treat metastatic non-small cell lung cancer (NSCLC). Stereotactic body radiotherapy (SBRT), also known as stereotactic ablation radiotherapy (SABR), can precisely deliver a high dose of radiation to a target in a limited area. SBRT has been established as the standard treatment for patients with early NSCLC who are unsuitable for operation or refuse surgery and patients with oligometastatic NSCLC who are not suitable for surgery. As an immunologic agent, pembrolizumab has been approved to treat metastatic NSCLC in certain countries, including China and the United States. Increased tumor proportion score (TPS) can reduce pembrolizumab's immunotherapeutic effect, while SBRT can reduce TPS and enhance immunotherapy efficacy. However, there have been no reports in China on metastatic NSCLC patients who have received pembrolizumab monotherapy after stereotactic body radiotherapy (SBRT). Here, we present a case of progression-free survival (PFS) of nearly 5 years with pembrolizumab monotherapy after SBRT for metastatic NSCLC. This case is the patient with the most prolonged medication duration and who experienced the most efficacious treatment among the patients with metastatic NSCLC reported in the Chinese literature.
肺癌是全球发病率和死亡率最高的恶性肿瘤。放射治疗、化学治疗、靶向治疗和免疫治疗已广泛应用于转移性非小细胞肺癌（NSCLC）的治疗。立体定向体部放疗（SBRT），也称为立体定向消融放疗（SABR），能够在有限区域内将高剂量辐射精确地传递至靶区。SBRT已成为不适于手术或拒绝手术的早期NSCLC患者以及不适于手术的寡转移NSCLC患者的标准治疗方法。帕博利珠单抗作为一种免疫制剂，已在包括中国和美国在内的某些国家被批准用于治疗转移性NSCLC。肿瘤比例评分（TPS）升高会降低帕博利珠单抗的免疫治疗效果，而SBRT可降低TPS并增强免疫治疗疗效。然而，在中国尚无关于立体定向体部放疗（SBRT）后接受帕博利珠单抗单药治疗的转移性NSCLC患者的报道。在此，我们报告1例转移性NSCLC患者在SBRT后接受帕博利珠单抗单药治疗获得近5年无进展生存期（PFS）的病例。该病例是中国文献报道的转移性NSCLC患者中用药持续时间最长且治疗效果最佳的患者。
