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信迪利单抗联合贝伐单抗及铂类化疗治疗后,一名预处理过的微卫星稳定、突变型结肠癌患者达到完全缓解:病例报告及文献综述

Complete remission in a pretreated, microsatellite-stable, -mutated colon cancer patient after treatment with sintilimab and bevacizumab and platinum-based chemotherapy: a case report and literature review.

作者信息

He Lijuan, Li Haiyuan, Wang Yunpeng, Li Weidong, Gao Lei, Xu Bo, Hu Jike, He Puyi, Pu Weigao, Sun Guodong, Wang Zhuanfang, Han Qinying, Liu Ben, Chen Hao

机构信息

Lanzhou University Second Hospital, Lanzhou, China.

Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou, China.

出版信息

Front Immunol. 2024 Mar 28;15:1354613. doi: 10.3389/fimmu.2024.1354613. eCollection 2024.

DOI:10.3389/fimmu.2024.1354613
PMID:38617840
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11010642/
Abstract

Metastatic colon cancer remains an incurable disease, and it is difficult for existing treatments to achieve the desired clinical outcome, especially for colon cancer patients who have received first-line treatment. Although immune checkpoint inhibitors (ICIs) have demonstrated durable clinical efficacy in a variety of solid tumors, their response requires an inflammatory tumor microenvironment. However, microsatellite-stable () colon cancer, which accounts for the majority of colorectal cancers, is a cold tumor that does not respond well to ICIs. Combination regimens open the door to the utility of ICIs in cold tumors. Although combination therapies have shown their advantage even for colon cancer, it remains unclear whether combination therapies show their advantage in patients with pretreated metastatic colon cancer. We report a patient who has achieved complete remission and good tolerance with sintilimab plus bevacizumab and platinum-based chemotherapy after postoperative recurrence. The patient had mutation and -type colon cancer, and his PD-1CD8 and CD3CD19CD14CD16HLA-DR were both positive. He has achieved a progression-free survival of 43 months and is still being followed up at our center. The above results suggest that this therapeutic regimen is a promising treatment modality for the management of pretreated, -type and -mutated metastatic colorectal cancer although its application to the general public still needs to be validated in clinical trials.

摘要

转移性结肠癌仍然是一种无法治愈的疾病,现有治疗方法难以达到理想的临床疗效,尤其是对于接受过一线治疗的结肠癌患者。尽管免疫检查点抑制剂(ICIs)在多种实体瘤中已显示出持久的临床疗效,但其应答需要炎性肿瘤微环境。然而,占大多数结直肠癌的微卫星稳定( )结肠癌是一种对ICIs反应不佳的“冷肿瘤”。联合治疗方案为ICIs在“冷肿瘤”中的应用打开了大门。尽管联合疗法即使对 结肠癌也已显示出优势,但对于经治转移性结肠癌患者联合疗法是否具有优势仍不清楚。我们报告了1例术后复发的患者,接受信迪利单抗联合贝伐单抗及铂类化疗后获得完全缓解且耐受性良好。该患者为 突变及 型结肠癌,其PD-1⁺CD8⁺及CD3⁺CD19⁻CD14⁻CD16⁺HLA-DR⁺均为阳性。他已获得43个月的无进展生存期,目前仍在本中心随访。上述结果表明,尽管该治疗方案应用于普通人群仍需在临床试验中验证,但它是治疗经治、 型及 突变转移性结直肠癌的一种有前景的治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/edabb65f99f4/fimmu-15-1354613-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/ae0d68840b0f/fimmu-15-1354613-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/65191be72cf8/fimmu-15-1354613-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/a452c0f779aa/fimmu-15-1354613-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/cfb67c493525/fimmu-15-1354613-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/8378d9739a10/fimmu-15-1354613-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/104a634f3fa4/fimmu-15-1354613-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/edabb65f99f4/fimmu-15-1354613-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/ae0d68840b0f/fimmu-15-1354613-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/65191be72cf8/fimmu-15-1354613-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/a452c0f779aa/fimmu-15-1354613-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/cfb67c493525/fimmu-15-1354613-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/8378d9739a10/fimmu-15-1354613-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/104a634f3fa4/fimmu-15-1354613-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209f/11010642/edabb65f99f4/fimmu-15-1354613-g007.jpg

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本文引用的文献

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Sintilimab plus bevacizumab, oxaliplatin and capecitabine as first-line therapy in RAS-mutant, microsatellite stable, unresectable metastatic colorectal cancer: an open-label, single-arm, phase II trial.信迪利单抗联合贝伐珠单抗、奥沙利铂和卡培他滨作为RAS突变、微卫星稳定、不可切除转移性结直肠癌的一线治疗:一项开放标签、单臂、II期试验。
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Sintilimab plus bevacizumab and CapeOx (BBCAPX) on first-line treatment in patients with RAS mutant, microsatellite stable, metastatic colorectal cancer: study protocol of a randomized, open-label, multicentric study.信迪利单抗联合贝伐珠单抗和卡培他滨/奥沙利铂(BBCAPX)一线治疗 RAS 基因突变、微卫星稳定、转移性结直肠癌患者:一项随机、开放标签、多中心研究的研究方案。
BMC Cancer. 2023 Jul 18;23(1):676. doi: 10.1186/s12885-023-11139-z.
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Practical notes on the current ESMO consensus guidelines for the management of patients with metastatic colorectal cancer in resource-constrained environments of low- to middle-income countries.关于欧洲肿瘤内科学会(ESMO)现行转移性结直肠癌患者管理共识指南在低收入和中等收入国家资源受限环境中的实用笔记。
Oncology. 2023 Mar 23;101(1):5-8. doi: 10.1159/000530275.
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Advances in immune checkpoint inhibitor combination strategies for microsatellite stable colorectal cancer.微卫星稳定型结直肠癌免疫检查点抑制剂联合策略的进展
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