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罕见的小细胞肺癌与肺鳞状细胞癌联合病例对PD-1抑制剂作为三线治疗的反应:一例报告

Rare Combined Small Cell Lung Carcinoma and Lung Squamous Cell Carcinoma Response to PD-1 Inhibitor as Third-Line Therapy: A Case Report.

作者信息

Liu Zhisheng, Zhang Junling, Ge Yunjie, Huang Mengli, Wang Ye

机构信息

Department of General Surgery, Affiliated Qingdao Hiser Hospital of Qingdao University (Qingdao Hospital of Traditional Chinese Medicine), Qingdao, Shandong People's Republic of China.

Medical Department, 3D Medicines Inc, Shanghai, People's Republic of China.

出版信息

Cancer Manag Res. 2023 Feb 22;15:197-201. doi: 10.2147/CMAR.S397711. eCollection 2023.

Abstract

BACKGROUND

Combined small cell lung cancer (c-SCLC) is a relatively rare subtype of SCLC, especially when SCLC is initially diagnosed and recurrent lesions are non-small cell lung cancer (NSCLC). Moreover, SCLC combined lung squamous cell carcinoma (LUSC) has few been reported.

CASE PRESENTATION

Here, we report a 68-year-old man pathologically diagnosed as stage IV SCLC of right lung. With cisplatin and etoposide, the lesions were significantly reduced. It was not until three years later that a new lesion was found in his left lung, pathologically confirmed as LUSC. The patient was initiated with sintilimab based on high tumor mutational burden (TMB-H). Both lung tumors were stable, and PFS was 9.7 months.

CONCLUSION

This case provides a meaningful reference for the third-line treatment of SCLC combined LUCS patients. This case also provides valuable information on the response to PD-1 inhibition of patients with c-SCLC based on TMB-H and better understanding of PD-1 therapy applications in the future.

摘要

背景

小细胞肺癌合并其他类型(c-SCLC)是小细胞肺癌中一种相对罕见的亚型,尤其是当小细胞肺癌最初被诊断且复发病变为非小细胞肺癌(NSCLC)时。此外,小细胞肺癌合并肺鳞状细胞癌(LUSC)的报道很少。

病例介绍

在此,我们报告一名68岁男性,经病理诊断为右肺IV期小细胞肺癌。使用顺铂和依托泊苷治疗后,病灶明显缩小。直到三年后,在他的左肺发现了一个新病灶,病理证实为LUSC。基于高肿瘤突变负荷(TMB-H),该患者开始使用信迪利单抗治疗。两个肺部肿瘤均稳定,无进展生存期为9.7个月。

结论

该病例为小细胞肺癌合并肺鳞状细胞癌患者的三线治疗提供了有意义的参考。该病例还为基于TMB-H的c-SCLC患者对PD-1抑制的反应提供了有价值的信息,并有助于未来更好地理解PD-1治疗的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a6e/9968780/d265b7febde0/CMAR-15-197-g0001.jpg

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