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新辅助纳武单抗联合化疗后行手术切除治疗高PD-L1表达的肺上沟瘤:一例报告

Neoadjuvant nivolumab plus chemotherapy followed by resection for superior sulcus tumour with high PD-L1 expression: A case report.

作者信息

Nakaya Takahito, Hirai Yoshimitsu, Akamatsu Hiroaki, Kojima Fumiyoshi, Iguchi Hideto, Fusamoto Aya, Yata Yumi, Nagai Takahiro, Kitahara Daiki, Takakura Toshiaki, Nishimura Yoshiharu, Yamamoto Nobuyuki

机构信息

Department of Thoracic and Cardiovascular Surgery Wakayama Medical University Wakayama Japan.

Internal Medicine III Wakayama Medical University Wakayama Japan.

出版信息

Respirol Case Rep. 2024 Apr 25;12(5):e01358. doi: 10.1002/rcr2.1358. eCollection 2024 May.

Abstract

The standard treatment for resectable non-small cell lung cancer (NSCLC) located in the superior sulcus is neoadjuvant chemoradiotherapy followed by highly invasive resection. Based on the results of the CheckMate 816 trial, which showed a marked improvement in the efficacy of neoadjuvant chemo-immunotherapy, we report a case of minimally invasive resection after neoadjuvant nivolumab plus chemotherapy for superior sulcus NSCLC, resulting in a pathologic complete response. The patient was a 76-year-old man with a 65-mm right superior sulcus tumour diagnosed as squamous cell carcinoma with 95% PD-L1. After two courses of neoadjuvant nivolumab plus chemotherapy, the tumour was completely resected through an 11-cm right lateral thoracotomy with second rib resection and first rib preservation. No residual tumour cells were observed in the specimen, and the patient had a pathologic complete response. This report represents a new treatment option for superior sulcus tumours.

摘要

位于肺上沟的可切除非小细胞肺癌(NSCLC)的标准治疗方法是新辅助放化疗,随后进行高侵入性切除。基于CheckMate 816试验的结果,该试验显示新辅助化疗联合免疫治疗的疗效有显著改善,我们报告了1例肺上沟NSCLC患者在接受新辅助纳武利尤单抗联合化疗后进行微创切除,结果达到病理完全缓解的病例。患者为一名76岁男性,右肺上沟有一个65mm的肿瘤,诊断为鳞状细胞癌,PD-L1表达为95%。经过两个疗程的新辅助纳武利尤单抗联合化疗后,通过11cm的右外侧开胸手术,切除第二肋骨并保留第一肋骨,将肿瘤完全切除。标本中未观察到残留肿瘤细胞,患者达到病理完全缓解。本报告代表了肺上沟肿瘤的一种新治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cea/11045440/e9054d6858db/RCR2-12-e01358-g002.jpg

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