Yang Jie, Xia Haoran, Sun Fenghuan, Zhang Peng, Jiang Gening
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Medical Graduate School of Nanchang University, Nanchang, China.
Ann Transl Med. 2021 Apr;9(8):724. doi: 10.21037/atm-21-1565.
Immunotherapy has revolutionized lung cancer management and revitalized the field of tumor immunology. Anti-programmed death 1 (anti-PD-1) immunotherapy can significantly improve the survival of patients with advanced non-small cell lung cancer (NSCLC), but its role in neoadjuvant therapy of local advanced NSCLC remains uncertain. Herein, we reported a case from a clinical trial of our department, a patient who achieved excellent outcome after neoadjuvant immunotherapy and chemotherapy for local advanced NSCLC. A 70 years old male patient with stage IIIA squamous cell carcinoma was admitted in our hospital, who initially needed to undergo pneumonectomy. After two cycles of neoadjuvant immunotherapy combined with chemotherapy, the tumor significantly shrank and the patient underwent left upper lobectomy finally. The patient had grade 2 myelosuppression and recovered after injection with recombinant human granulocyte colony stimulating factor. There was no operation-related complication the patient was discharged uneventfully. The patient received two cycles adjuvant chemotherapy combined with immunotherapy, then immunotherapy alone monthly. The patient was well during the 4-month follow-up after surgery and would receive immunotherapy till one year after surgery. Our case added evidence of the feasibility and efficacy of neoadjuvant immunotherapy combined with chemotherapy in local advanced NSCLC. Randomized, controlled, multi-center studies are needed to confirm these findings.
免疫疗法彻底改变了肺癌的治疗方式，并使肿瘤免疫学领域重焕生机。抗程序性死亡1（anti-PD-1）免疫疗法可显著提高晚期非小细胞肺癌（NSCLC）患者的生存率，但其在局部晚期NSCLC新辅助治疗中的作用仍不明确。在此，我们报告了来自本部门一项临床试验的病例，一名局部晚期NSCLC患者在接受新辅助免疫疗法和化疗后取得了优异的治疗效果。一名70岁的III A期鳞状细胞癌男性患者入住我院，最初需要进行肺切除术。经过两个周期的新辅助免疫疗法联合化疗后，肿瘤明显缩小，患者最终接受了左上叶切除术。患者出现2级骨髓抑制，注射重组人粒细胞集落刺激因子后恢复。患者无手术相关并发症，顺利出院。患者接受了两个周期的辅助化疗联合免疫疗法，然后每月单独接受免疫疗法。术后4个月的随访期间患者情况良好，术后一年内将接受免疫疗法。我们的病例增加了新辅助免疫疗法联合化疗在局部晚期NSCLC中的可行性和疗效的证据。需要进行随机、对照、多中心研究来证实这些发现。
