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免疫检查点抑制剂诱导的甲状腺功能障碍与非小细胞肺癌新辅助治疗期间的肿瘤进展:一例报告及文献综述

Thyroid dysfunction induced by immune checkpoint inhibitors and tumor progression during neoadjuvant therapy of non‑small cell lung cancer: A case report and literature review.

作者信息

Li Xinyi, Wang Xun, Wang Shaodong, Liu Yanguo, Wang Ruilin, Liu Yi, Huang Lin, Feng Yufei, Xie Xiaohui, Shi Luwen

机构信息

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, P.R. China.

Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100044, P.R. China.

出版信息

Oncol Lett. 2023 Sep 29;26(5):496. doi: 10.3892/ol.2023.14083. eCollection 2023 Nov.

Abstract

Immune checkpoint inhibitors (ICIs) have a demonstrable treatment response in patients with resectable non-small cell lung cancer (NSCLC). However, immune-related adverse events and tumor progression in patients administered ICIs are of great concern. The present case study is of a 59-year-old male with NSCLC (squamous, stage IIIA) who received neoadjuvant immunotherapy combined with chemotherapy before surgery. The patient first developed hyperthyroidism and then hypothyroidism, indicating that ICI-related thyroid dysfunction had occurred. Furthermore, the patient suffered from tumor progression and could not undergo resection. The present case called attention to the prevention and management of irAEs, and the precaution that should be taken with regard to tumor progression. The case also suggested that the development of ICI-related thyroid dysfunction may not predict an improved response to ICI therapies, which needs further evidence to illustrate.

摘要

免疫检查点抑制剂(ICI)在可切除的非小细胞肺癌(NSCLC)患者中具有明显的治疗反应。然而,接受ICI治疗的患者出现的免疫相关不良事件和肿瘤进展备受关注。本病例研究的是一名59岁的NSCLC(鳞状,ⅢA期)男性患者,其在手术前接受了新辅助免疫治疗联合化疗。该患者首先出现甲状腺功能亢进,随后出现甲状腺功能减退,提示发生了ICI相关的甲状腺功能障碍。此外,患者出现肿瘤进展,无法进行手术切除。本病例提请注意免疫相关不良事件的预防和管理,以及肿瘤进展应采取的预防措施。该病例还表明,ICI相关甲状腺功能障碍的发生可能无法预测对ICI治疗反应的改善,这需要进一步的证据来说明。

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