Wang Juan, Gao Yong-Sheng, Xu Kun, Li Xiao-Dong
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
Department of Pathology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
World J Clin Cases. 2022 Feb 16;10(5):1609-1616. doi: 10.12998/wjcc.v10.i5.1609.
The prognosis of refractory extranodal natural killer/T-cell lymphoma (ENKTL) is poor. Recent data have indicated that immune checkpoint blockade with a programmed cell death protein-1 (PD-1) antibody in combination with administration of histone deacetylase inhibitors represents a potentially effective treatment strategy. Compared with PD-1 antibodies, programmed death-ligand 1 antibodies have fewer side effects. Here, we present a rare case of a patient with refractory metastatic ENKTL who achieved sustained remission of approximately 10 mo with minor adverse effects after combination therapy with atezolizumab, chidamide, and radiotherapy.
A 56-year-old woman underwent resection of a tumour in her left nasal cavity and was diagnosed with ENKTL (nasal type). Medical examination revealed tumours observed in the bilateral nasal mucosa, the subcutaneous soft tissue of the inner side of the left eye, the soft tissue of the nasopharynx, the bilateral tonsils, and the left preauricular, right hilar, bilateral neck lymph nodes and bone marrow. However, tomography/computed tomography showed increased metabolism of the bilateral nasal mucosa and subcutaneous soft tissue of the inner side of the left eye and newly increased metabolism of the left cervical lymph node after chemotherapy. Therefore, combination therapy with chidamide, atezolizumab, and radiotherapy was performed. Fortunately, the patient achieved a complete response following 10 mo of combination therapy.
The outcome in this case suggests that the combination of atezolizumab, chidamide, and radiotherapy is a promising regimen for treating refractory metastatic ENKTL following chemotherapy treatment failure.
难治性结外自然杀伤/T细胞淋巴瘤（ENKTL）的预后较差。近期数据表明，程序性死亡蛋白1（PD-1）抗体免疫检查点阻断联合组蛋白去乙酰化酶抑制剂给药是一种潜在有效的治疗策略。与PD-1抗体相比，程序性死亡配体1抗体的副作用更少。在此，我们报告1例难治性转移性ENKTL患者的罕见病例，该患者在接受阿替利珠单抗、西达本胺和放疗联合治疗后，实现了约10个月的持续缓解，且不良反应轻微。
一名56岁女性接受了左鼻腔肿瘤切除术，被诊断为ENKTL（鼻型）。医学检查发现双侧鼻黏膜、左眼内侧皮下软组织、鼻咽部软组织、双侧扁桃体以及左耳前、右肺门、双侧颈部淋巴结和骨髓均有肿瘤。然而，断层扫描/计算机断层扫描显示化疗后双侧鼻黏膜和左眼内侧皮下软组织代谢增加，左颈淋巴结出现新的代谢增加。因此，进行了西达本胺、阿替利珠单抗和放疗联合治疗。幸运的是，联合治疗10个月后患者实现了完全缓解。
该病例结果表明，阿替利珠单抗、西达本胺和放疗联合治疗是化疗失败后难治性转移性ENKTL的一种有前景的治疗方案。
