Department of Medical Oncology, City of Hope, Duarte, California 91010, USA.
Department of Pathology, City of Hope, Duarte, California 91010, USA.
Cold Spring Harb Mol Case Stud. 2023 May 9;9(2). doi: 10.1101/mcs.a006262. Print 2023 Apr.
A small percentage of patients have multiple synchronous primary cancers at presentation. In the last five years, many regimens associated with immunotherapy and chemotherapy were approved for first-line metastatic non-small-cell lung cancer (NSCLC) and other solid tumors, but the study of immunotherapy when multiple cancers are present in one patient remains incomplete. Next-generation sequencing biomarkers and immunotherapy markers including PD-L1 can be effectively utilized in the diagnosis and treatment plan for multiple synchronous primary cancers. Immune biomarkers and PD-L1 expression warrant individualized treatments in synchronous primary adenocarcinoma and pulmonary sarcomatoid carcinoma. We describe the case of a patient with pulmonary sarcomatoid carcinoma and lung adenocarcinoma, metastatic to brain de novo. The patient achieved a complete response after only three cycles of carboplatin, paclitaxel, bevacizumab, and atezolizumab and remains free of any evidence of disease after 18 mo of maintenance therapy.
一小部分患者在就诊时就患有多个同时性原发性癌症。在过去五年中，许多与免疫疗法和化疗相关的方案已被批准用于一线转移性非小细胞肺癌（NSCLC）和其他实体瘤，但对同时存在多种癌症的患者进行免疫疗法的研究仍不完整。下一代测序生物标志物和免疫治疗标志物，包括 PD-L1，可以有效地用于多个同时性原发性癌症的诊断和治疗计划。免疫生物标志物和 PD-L1 表达需要对同时性肺腺癌和肺肉瘤样癌进行个体化治疗。我们描述了一例肺肉瘤样癌和肺腺癌患者的病例，该患者脑转移，为初发。该患者在接受卡铂、紫杉醇、贝伐珠单抗和阿替利珠单抗三个周期治疗后达到完全缓解，在 18 个月的维持治疗后仍无任何疾病证据。
