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替雷利珠单抗联合阿帕替尼治疗晚期肾透明细胞癌 1 例报告。

Tislelizumab combined with apatinib in the treatment of advanced renal clear cell carcinoma: a case report.

机构信息

Department of Oncology, Dalian Third People's Hospital, Dalian, China.

出版信息

Anticancer Drugs. 2022 Jan 1;33(1):e834-e839. doi: 10.1097/CAD.0000000000001241.

Abstract

Most patients with advanced renal cancer develop drug resistance to targeted drugs, and the disease progresses with the prolongation of the treatment cycle. Therefore, it is necessary to explore new treatment methods for advanced renal cancer to obtain continuous efficacy and prolong the survival time of patients. The patient was diagnosed with advanced renal cancer that had progressed after previous antiangiogenic drug therapy, based on the clinical course and imaging findings. The patient was treated with 'tislelizumab plus apatinib'. The clinical discomfort symptoms were quickly relieved after treatment, and the evaluation two cycles later showed stable disease. After two cycles of continuation of the original regimen, reevaluation computed tomography demonstrated a significant reduction in the size of the abdominal cavity mass and the therapeutic evaluation was partial remission after four cycles; however, the patient developed abnormal liver function after treatment, manifested as nausea and poor appetite, and significantly increased bilirubin and transaminase levels, which were considered as immune-related liver injuries. After glucocorticoid treatment, the patient's condition quickly improved and recovered. This report is the first to suggest a potential approach to advanced renal clear cell carcinoma and describes the effects of immunocombination therapy on advanced renal clear cell carcinoma; the results showed the current stage success of the immunocombination treatment, suggesting that this treatment may be an effective treatment option for patients with advanced renal clear cell carcinoma. In addition, the toxic and side effects of combined immunotherapy need to be carefully identified by every doctor. Since only one patient with advanced renal cancer was observed in this report, the clinical data are very limited and further observation and accumulation of more experience are needed, and further clinical studies will be conducted on the efficacy and safety of this combination regimen.

摘要

大多数晚期肾癌患者对靶向药物产生耐药性,并且随着治疗周期的延长疾病会进展。因此,有必要探索新的治疗方法来治疗晚期肾癌,以获得持续的疗效并延长患者的生存时间。该患者在接受先前的抗血管生成药物治疗后进展为晚期肾癌,基于临床过程和影像学发现。该患者接受了“替雷利珠单抗联合阿帕替尼”治疗。治疗后,临床不适症状迅速缓解,两个周期后的评估显示病情稳定。在继续原方案两个周期后,重新评估计算机断层扫描显示腹腔肿块明显缩小,治疗评估为部分缓解,四个周期后;然而,患者在治疗后出现肝功能异常,表现为恶心、食欲不振,胆红素和转氨酶水平显著升高,被认为是免疫相关肝损伤。在糖皮质激素治疗后,患者的病情迅速改善并恢复。本报告首次提出了一种治疗晚期肾透明细胞癌的潜在方法,并描述了免疫联合治疗对晚期肾透明细胞癌的疗效;结果显示免疫联合治疗的现阶段成功,提示这种治疗可能是晚期肾透明细胞癌患者的有效治疗选择。此外,联合免疫治疗的毒性和副作用需要每位医生仔细识别。由于本报告仅观察到一名晚期肾癌患者,临床数据非常有限,需要进一步观察和积累更多经验,并对该联合方案的疗效和安全性进行进一步的临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e5f/8670338/8b32173e2ad8/acd-33-e834-g001.jpg

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