Ducceschi Monika, Polignano Maggie, Bini Marta, Lopez Salvatore, Conca Elena, Tamborini Elena, Perrone Federica, Carlo Stella Giulia, Petrella Maria Cristina, Carciotto Rosaria, Artioli Grazia, Maffeis Valeria, Sartor Lucia, Raspagliesi Francesco, Mantiero Mara
Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy.
Department of Innovation Diagnostics, Laboratory of Molecular Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy.
J Clin Med. 2023 Aug 25;12(17):5540. doi: 10.3390/jcm12175540.
Patients with solid tumors and mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H) are eligible for immunotherapy. Recently, different reports described patients with poor performance status (PS), unrelated to comorbidities, which showed a rapid improvement of their clinical conditions under immunotherapy, which evoked a Lazarus response. Very few data on the efficacy and safety of immunotherapy in patients with gynecological malignancies and poor PS are available. Based on the GARNET trial, Dostarlimab, a monoclonal antibody anti-programmed death receptor-1 (PD-1), has been approved in advanced or recurrent mismatch repair deficient endometrial cancer (EC) which progressed after platinum-based therapy. For the first time, in gynecological oncology, an immune checkpoint inhibitor drastically changed the clinical practice. We collected a multicenter case series of six patients with advanced endometrial carcinoma and PS ECOG 3-4 treated with Dostarlimab, showing exceptionally quick responses and significant improvement of PS to configure a Lazarus response.
实体瘤且存在错配修复缺陷（dMMR）或微卫星高度不稳定（MSI-H）的患者适合接受免疫治疗。最近，不同报告描述了体能状态（PS）较差且与合并症无关的患者，这些患者在免疫治疗下临床状况迅速改善，即出现了拉撒路反应。关于免疫治疗在妇科恶性肿瘤且PS较差患者中的疗效和安全性的数据非常少。基于GARNET试验，抗程序性死亡受体-1（PD-1）单克隆抗体多斯塔利单抗已被批准用于铂类治疗后进展的晚期或复发性错配修复缺陷子宫内膜癌（EC）。在妇科肿瘤学中，免疫检查点抑制剂首次极大地改变了临床实践。我们收集了一个多中心病例系列，6例ECOG 3-4级的晚期子宫内膜癌患者接受了多斯塔利单抗治疗，显示出异常快速的反应和PS的显著改善，构成了拉撒路反应。
