Department of Biotherapy, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Immunol. 2023 Oct 12;14:1254812. doi: 10.3389/fimmu.2023.1254812. eCollection 2023.
Primary urethral carcinoma (PUC) has a low incidence, but with high aggressiveness. Most of the patients are found in late stage, with poor prognosis. At present, chemotherapy is still the main treatment for metastatic PUC, but it has limited effect. Here, we report a case of metastatic PUC with low HER2 expression that developed disease progression after multiline therapy including chemotherapy, programmed death-1 (PD-1) inhibitors and multi-targeted receptor tyrosine kinase (RTK) inhibitor. After receiving Disitamab Vedotin(a novel antibody drug conjugate, ADC) and toripalimab (a PD-1 inhibitor), the patient achieved persistent PR, and the PFS exceeded 12 months up to now. Our report indicates that, despite the patient of metastatic PUC has low expression of HER2, it is still possible to benefit from Disitamab Vedotin combined with PD-1 inhibitor, which may reverse the drug resistance of PD-1 inhibitor and chemotherapy to a certain extent. But larger sample studies are needed to determine the efficacy of this treatment strategy and its impact on survival.
原发性尿道癌（PUC）发病率低，但侵袭性强。大多数患者在晚期被发现，预后不良。目前，化疗仍然是转移性 PUC 的主要治疗方法，但效果有限。在这里，我们报告了一例 HER2 低表达的转移性 PUC 患者，该患者在接受包括化疗、程序性死亡受体-1（PD-1）抑制剂和多靶点受体酪氨酸激酶（RTK）抑制剂在内的多线治疗后发生疾病进展。在接受注射用维迪西妥单抗（一种新型抗体药物偶联物，ADC）和特瑞普利单抗（一种 PD-1 抑制剂）治疗后，患者获得了持续的部分缓解（PR），截至目前，无进展生存期（PFS）超过 12 个月。我们的报告表明，尽管转移性 PUC 患者的 HER2 表达水平较低，但仍有可能从注射用维迪西妥单抗联合 PD-1 抑制剂中获益，这可能在一定程度上逆转 PD-1 抑制剂和化疗的耐药性。但需要更大样本的研究来确定这种治疗策略的疗效及其对生存的影响。
