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一线化疗失败后碘-125粒子近距离放疗联合帕博利珠单抗治疗晚期非小细胞肺癌:2例报告及文献复习

Iodine-125 seed brachytherapy combined with pembrolizumab for advanced non-small-cell lung cancer after failure of first-line chemotherapy: A report of two cases and literature review.

作者信息

Yuan Mingli, Wang Liangchao, Xiao Yang, Guo Xiaoqun, Hu Yi

机构信息

Department of Pulmonary and Critical Care Medicine, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Contemp Brachytherapy. 2023 Feb;15(1):81-88. doi: 10.5114/jcb.2023.125582. Epub 2023 Feb 28.

Abstract

Although immunotherapy regimens for advanced non-small-cell lung cancer (NSCLC) improve survival in selected sub-populations, their efficacy remains far from ideal due to underlying resistance; therefore, multimodal combination strategies are needed to optimize their efficacy. In our report, two patients with advanced NSCLC with negative targetable mutations, who had failed first-line chemotherapy were treated with combined therapy of computed tomography (CT)-guided percutaneous iodine-125 seed implantation and pembrolizumab. After combination treatment, both patients achieved partial response (PR), and sustained a long progression-free survival (PFS) without obvious therapy-related adverse reactions. Iodine-125 seeds bring no long-term adverse events and effectively amplify anti-tumor immune response induced by immunotherapy; thus, this combined therapy might be a promising alternative for NSCLC.

摘要

尽管晚期非小细胞肺癌(NSCLC)的免疫治疗方案可提高特定亚群患者的生存率,但由于潜在的耐药性,其疗效仍远不理想;因此,需要多模式联合策略来优化其疗效。在我们的报告中,两名一线化疗失败的晚期NSCLC患者,具有不可靶向的阴性突变,接受了计算机断层扫描(CT)引导下经皮碘-125粒子植入联合帕博利珠单抗治疗。联合治疗后,两名患者均获得部分缓解(PR),并维持了较长的无进展生存期(PFS),且无明显的治疗相关不良反应。碘-125粒子不会带来长期不良事件,并能有效增强免疫治疗诱导的抗肿瘤免疫反应;因此,这种联合治疗可能是NSCLC的一种有前景的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36a/10034723/502d8635130b/JCB-15-50249-g001.jpg

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