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携带 扩增的难治性弥漫性大 B 细胞淋巴瘤患者接受信迪利单抗单药治疗实现部分缓解:一例报告

Partial remission with sintilimab monotherapy in a patient carrying a amplification in refractory diffuse large B‑cell lymphoma: A case report.

作者信息

Zhang Xian, Xu Liye, Pan Evenki, Sun Xiuhua, Ding Xiaolei

机构信息

Department of Medical Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China.

Department of Medical Services, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu 210031, P.R. China.

出版信息

Oncol Lett. 2024 Apr 30;27(6):289. doi: 10.3892/ol.2024.14423. eCollection 2024 Jun.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with varying characteristics, in terms of genomic variation, cell morphology and clinical presentation. At present, only ~66% of patients are cured with initial treatment and those with refractory DLBCL exhibit a poor prognosis. Thus, further investigations into novel effective treatment options for DLBCL are required. The present study reports the case of a patient resistant to multiple therapies, including rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) plus enzastaurin (trial no. CTR20171560), GemOx plus lenalidomide and selinexor (trial no. ATG-010-DLBCL-001). The patient harbored a amplification, as identified via next-generation sequencing (NGS), and exhibited a high programmed death-ligand 1 Tumor Proportion Score of up to 95%. Consequently, the patient was treated with sintilimab monotherapy and the response lasted for 12 months of follow-up without major immune-related adverse events. This case highlights the role of NGS technology in selecting treatment options for refractory DLBCL. Furthermore, the results of the present study suggest that sintilimab may have potential in the treatment of patients with refractory DLBCL.

摘要

弥漫性大B细胞淋巴瘤(DLBCL)是一种具有不同特征的异质性疾病,在基因组变异、细胞形态和临床表现方面均有所不同。目前,仅有约66%的患者通过初始治疗得以治愈,而难治性DLBCL患者的预后较差。因此,需要进一步研究针对DLBCL的新型有效治疗方案。本研究报告了1例对多种治疗耐药的患者,这些治疗包括利妥昔单抗联合环磷酰胺、阿霉素、长春新碱和泼尼松(R-CHOP)加恩杂鲁胺(试验编号CTR20171560)、吉西他滨联合奥沙利铂加来那度胺和塞利尼索(试验编号ATG-010-DLBCL-001)。通过下一代测序(NGS)鉴定,该患者存在 扩增,且程序性死亡配体1肿瘤比例分数高达95%。因此,该患者接受了信迪利单抗单药治疗,反应持续了12个月的随访期,且未出现严重的免疫相关不良事件。该病例突出了NGS技术在为难治性DLBCL选择治疗方案中的作用。此外,本研究结果表明,信迪利单抗在治疗难治性DLBCL患者方面可能具有潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9686/11083924/21146d7b2f71/ol-27-06-14423-g00.jpg

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