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免疫检查点抑制剂、放疗和化疗后晚期非小细胞肺癌的完全持续缓解

A Complete Sustained Response of Advanced Non-Small-Cell Lung Cancer After Immune Checkpoint Inhibitor, Radiotherapy, and Chemotherapy.

作者信息

Vilas-Boas Isabel, Moreira Inês, Rodrigues Ana

机构信息

Medical Oncology, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, PRT.

出版信息

Cureus. 2022 Dec 16;14(12):e32585. doi: 10.7759/cureus.32585. eCollection 2022 Dec.

Abstract

Lung cancer is the leading cause of cancer-related mortality worldwide. The treatment of advanced lung cancer is improving with the development of new treatments like immune checkpoint inhibitors (ICIs) and various molecular targeted agents, which have extended overall survival (OS). However, complete remissions remain rare. The efficacy of chemotherapy is modest, which makes a complete sustained response very unlikely, especially when compared with more recent options. In this article, we report a stage IV non-small-cell lung cancer (SCLC) that achieved a complete response in 2018 with chemotherapy (cisplatin and paclitaxel) after pembrolizumab and after the patient had received radiotherapy for superior vena cava syndrome (SVCS). The patient remains in complete response as of October 2022. We hypothesized that the overlap between circulating anti-PD-1, radiotherapy, and cytotoxic agents could explain this outcome.

摘要

肺癌是全球癌症相关死亡的主要原因。随着免疫检查点抑制剂(ICIs)和各种分子靶向药物等新疗法的发展,晚期肺癌的治疗正在改善,这些新疗法延长了总生存期(OS)。然而,完全缓解仍然很少见。化疗的疗效一般,这使得完全持续缓解的可能性非常小,尤其是与更新的治疗方案相比。在本文中,我们报告了一例IV期非小细胞肺癌(NSCLC)患者,该患者在接受帕博利珠单抗治疗后,因上腔静脉综合征(SVCS)接受放疗,之后于2018年采用化疗(顺铂和紫杉醇)实现了完全缓解。截至2022年10月,该患者仍处于完全缓解状态。我们推测循环抗PD-1、放疗和细胞毒性药物之间的重叠可能解释了这一结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcfd/9840782/4c07d6e76745/cureus-0014-00000032585-i01.jpg

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