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接受免疫检查点抑制剂治疗的小细胞肺癌患者的假性进展性疾病

Pseudoprogression Disease in a Patient with Small Cell Lung Cancer on Immune Checkpoint Inhibitor Therapy.

作者信息

Zhu Wanshan, Wu Lexia, Wu Jiaming, Lin Sihong, Fang Cantu, Zhang Huatang

机构信息

Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, Guangdong Province, People's Republic of China.

出版信息

Cancer Manag Res. 2023 Sep 1;15:905-911. doi: 10.2147/CMAR.S418116. eCollection 2023.

Abstract

Small cell lung cancer (SCLC) accounts for approximately 15% of all lung cancers and is on the rise annually. It is characterized by low differentiation, high malignancy, and rapid growth. Consequently, treatment options are limited, and the patient's prognosis is poor. The emergence of immunotherapy has partially improved the survival and prognosis of SCLC patients. However, a unique response known as "pseudoprogression" during immunotherapy has raised concerns. The occurrence of tumor enlargement despite a positive response to immune checkpoint inhibitor therapy undoubtedly affects the assessment of clinical drug efficacy and the selection of subsequent treatment strategies. In this article, we analyze a clinical case of pseudoprogression in a patient with SCLC who received immune therapy (Durvalumab). Currently, there is insufficient evidence-based medicine to guide the diagnosis, differentiation and subsequent treatment strategies for pseudoprogression in SCLC following immunotherapy. Through this case report and literature review, we aim to provide diagnostic and therapeutic insights for the clinical use of immunotherapy in advanced SCLC. Additionally, we hope that fellow readers of this article can engage in further collaborative discussions through more clinical research.

摘要

小细胞肺癌(SCLC)约占所有肺癌的15%,且每年呈上升趋势。其特点是低分化、高恶性和生长迅速。因此,治疗选择有限,患者预后较差。免疫疗法的出现部分改善了SCLC患者的生存率和预后。然而,免疫疗法期间出现的一种称为“假性进展”的独特反应引发了关注。尽管对免疫检查点抑制剂治疗有阳性反应,但肿瘤仍出现增大,这无疑影响了临床药物疗效评估和后续治疗策略的选择。在本文中,我们分析了1例接受免疫治疗(度伐利尤单抗)的SCLC患者出现假性进展的临床病例。目前,循证医学证据不足,难以指导SCLC免疫治疗后假性进展的诊断、鉴别及后续治疗策略。通过本病例报告和文献复习,我们旨在为晚期SCLC免疫治疗的临床应用提供诊断和治疗方面的见解。此外,我们希望本文的读者能够通过更多的临床研究进行进一步的合作讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23af/10480285/3ec2b43117d0/CMAR-15-905-g0001.jpg

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