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采用多组学方法改善老年肺癌患者基于免疫检查点阻断和细胞因子诱导的杀伤细胞输注的个体化治疗:病例报告及文献综述

Multi‑omics approach to improve patient‑tailored therapy using immune checkpoint blockade and cytokine‑induced killer cell infusion in an elderly patient with lung cancer: A case report and literature review.

作者信息

Xing Yasi, Qin Fangyuan, Han Lei, Yang Jingwen, Zhang Hongrui, Qi Yong, Tu Shichun, Zhai Yaping

机构信息

Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450001, P.R. China.

Zhengzhou Shenyou Biotechnology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450001, P.R. China.

出版信息

Oncol Lett. 2024 Mar 11;27(5):203. doi: 10.3892/ol.2024.14334. eCollection 2024 May.

DOI:10.3892/ol.2024.14334
PMID:38516684
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10955685/
Abstract

The 5-year survival rate of patients with advanced non-small cell lung cancer (NSCLC) remains low, despite recent advances in targeted therapy and immunotherapy. Therefore, there is a need to identify alternative strategies to improve treatment outcomes. Modern diagnostics can significantly facilitate the selection of treatment plans to improve patient outcomes. In the present study, multi-form diagnostic methodologies were adopted, including next-generation sequencing-based actionable gene sequencing, programmed death ligand 1 (PD-L1) immunohistochemistry, a circulating tumor cell (CTC) assay, flow cytometric analysis of lymphocyte subsets and computed tomography, to improve disease management in an 86-year-old female patient with relapsed metastatic NSCLC. High expression of PD-L1, elevated CTC tmutations, were observed. Based on these results, the patient was initially treated with the programmed death protein 1 blocking antibody sintilimab for two cycles, resulting in the stabilization of their condition, although the patient still exhibited severe pain and other symptoms, including fatigue, malaise, a loss of appetite and poor mental state. Informed by dynamic monitoring of the patient's response to treatment, the treatment plan was subsequently adjusted to a combination therapy with sintilimab and autologous cytokine-induced killer cell infusion, which eventually led to improved outcomes in both the management of the cancer and quality of life. In conclusion, multi-omics analysis may be used to establish patient-tailored therapies to improve clinical outcomes in hard-to-treat elderly patients with metastatic NSCLC.

摘要

尽管靶向治疗和免疫治疗最近取得了进展,但晚期非小细胞肺癌(NSCLC)患者的5年生存率仍然很低。因此,需要确定其他策略来改善治疗效果。现代诊断方法可以显著促进治疗方案的选择,以改善患者的治疗效果。在本研究中,采用了多种诊断方法,包括基于下一代测序的可操作基因测序、程序性死亡配体1(PD-L1)免疫组织化学、循环肿瘤细胞(CTC)检测、淋巴细胞亚群的流式细胞术分析和计算机断层扫描,以改善一名86岁复发性转移性NSCLC女性患者的疾病管理。观察到PD-L1高表达、CTC突变增加。基于这些结果,患者最初接受了两个周期的程序性死亡蛋白1阻断抗体信迪利单抗治疗,病情得到了稳定,尽管患者仍表现出严重疼痛和其他症状,包括疲劳、不适、食欲不振和精神状态不佳。根据对患者治疗反应的动态监测,随后将治疗方案调整为信迪利单抗与自体细胞因子诱导的杀伤细胞输注联合治疗,最终在癌症管理和生活质量方面都取得了更好的结果。总之,多组学分析可用于制定针对患者的治疗方案,以改善难以治疗的老年转移性NSCLC患者的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/3219266a8d8c/ol-27-05-14334-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/1f7d8c2aad8a/ol-27-05-14334-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/67531332109e/ol-27-05-14334-g01.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/c6b01f4865c6/ol-27-05-14334-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/3219266a8d8c/ol-27-05-14334-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/1f7d8c2aad8a/ol-27-05-14334-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/67531332109e/ol-27-05-14334-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/486f83904bee/ol-27-05-14334-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/c6b01f4865c6/ol-27-05-14334-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c2/10955685/3219266a8d8c/ol-27-05-14334-g04.jpg

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本文引用的文献

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The Role of Immunotherapy in the First-Line Treatment of Elderly Advanced Non-Small Cell Lung Cancer.免疫疗法在老年晚期非小细胞肺癌一线治疗中的作用
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Revising the Landscape of Cytokine-Induced Killer Cell Therapy in Lung Cancer: Focus on Immune Checkpoint Inhibitors.修订肺癌细胞因子诱导的杀伤细胞治疗领域:聚焦免疫检查点抑制剂。
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Comprehensive genomic profiling of upper tract urothelial carcinoma and urothelial carcinoma of the bladder identifies distinct molecular characterizations with potential implications for targeted therapy & immunotherapy.
全面的上尿路尿路上皮癌和膀胱尿路上皮癌基因组分析确定了具有潜在靶向治疗和免疫治疗意义的不同分子特征。
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Three-Year Follow-Up of Neoadjuvant Programmed Cell Death Protein-1 Inhibitor (Sintilimab) in NSCLC.NSCLC 新辅助程序性死亡蛋白-1 抑制剂(信迪利单抗)治疗的 3 年随访结果。
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Outcomes of anti-programmed death 1 treatment for relapsed/refractory Hodgkin lymphoma: A German Hodgkin Study Group multicentre real-world analysis.抗程序性死亡1治疗复发/难治性霍奇金淋巴瘤的疗效:德国霍奇金淋巴瘤研究组多中心真实世界分析。
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Association of Clinical Features of Colorectal Cancer with Circulating Tumor Cells and Systemic Inflammatory Markers.结直肠癌的临床特征与循环肿瘤细胞和全身炎症标志物的相关性研究。
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