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新辅助PD-1阻断、VEGFR-2抑制剂联合化疗治疗潜在不可切除的食管胃交界部鳞状细胞癌的成功病例报告

Successful outcome of neoadjuvant PD-1 blockade, VEGFR-2 inhibitor plus chemotherapy for potentially unresectable esophagogastric junctional squamous cell carcinoma: a case report.

作者信息

Chen Kai-Bo, Wu Zhi-Wei, Huang Yi, Kang Mu-Xing, Lin Le-Le, Jiang Shan-Shan, Zhang Hui, Huang Ya-Jing, Chen Li

机构信息

Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.

Department of Pathology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.

出版信息

Transl Cancer Res. 2022 Sep;11(9):3329-3336. doi: 10.21037/tcr-22-789.

Abstract

BACKGROUND

Esophagogastric junctional squamous cell carcinoma (EJSCC) is quite rare among all gastric carcinoma, its potential resectable rate is low due to the late diagnosis. Recently, programmed death-1 (PD-1) blockade combined with anti-angiogenesis have gained accumulated clinical experiences in treating solid tumors. This is the first reported case with EJSCC who achieved a partial remission (PR) after neoadjuvant PD-1 blockade, vascular endothelial growth factor receptor 2 (VEGFR-2) inhibitor plus chemotherapy.

CASE DESCRIPTION

We present an EJSCC case treated with novel neoadjuvant treatment. A 64-year-old Chinese male had the symptom of chocking for 3 months. An enhanced abdominal computed tomography (CT) scan found a locally advanced, potentially unresectable esophagogastric junctional (EGJ) mass, and the preoperative immunohistochemistry result exhibited a highly positive programmed death-ligand 1 (PD-L1) expression, so the patient received three courses of neoadjuvant camrelizumab (200 mg/day), apatinib (750 mg/day), albumin paclitaxel (200 mg/day) and nedaplatin (70 mg/day), he was well tolerant without any adverse event, and he underwent radical surgery after a significant tumor shrinkage. The patient recovered well after surgery, and he has received four cycles of camrelizumab and apatinib as maintenance treatment. There is no recurrence 7 months after surgery.

CONCLUSIONS

PD-1 blockade, VEGFR-2 inhibitor plus chemotherapy is effective and safe for the patient with EJSCC.

摘要

背景

食管胃交界鳞状细胞癌(EJSCC)在所有胃癌中较为罕见,因其诊断较晚,潜在可切除率较低。近来,程序性死亡受体1(PD-1)阻断联合抗血管生成在实体瘤治疗中积累了临床经验。本文首次报道了1例EJSCC患者在接受新辅助PD-1阻断、血管内皮生长因子受体2(VEGFR-2)抑制剂联合化疗后获得部分缓解(PR)。

病例描述

我们报道1例采用新型新辅助治疗的EJSCC病例。一名64岁中国男性出现哽咽症状3个月。腹部增强计算机断层扫描(CT)发现局部进展期、潜在不可切除的食管胃交界(EGJ)肿物,术前免疫组化结果显示程序性死亡配体1(PD-L1)表达呈强阳性,因此患者接受了3个疗程的新辅助治疗,包括卡瑞利珠单抗(200mg/天)、阿帕替尼(750mg/天)、白蛋白紫杉醇(200mg/天)和顺铂(70mg/天),患者耐受性良好,未出现任何不良事件,在肿瘤显著缩小后接受了根治性手术。患者术后恢复良好,并接受了4个周期的卡瑞利珠单抗和阿帕替尼维持治疗。术后7个月无复发。

结论

PD-1阻断、VEGFR-2抑制剂联合化疗对EJSCC患者有效且安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b1b/9552059/4e2a0a03f1e3/tcr-11-09-3329-f1.jpg

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