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尼妥珠单抗联合免疫治疗青年复发性宫颈癌患者的疗效:病例报告及文献复习。

Efficacy of nimotuzumab in combination with immunotherapy for a young recurrent cervical cancer patient: a case report and literature review.

机构信息

Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Anticancer Drugs. 2024 Aug 1;35(7):644-652. doi: 10.1097/CAD.0000000000001611. Epub 2024 May 20.

Abstract

Cervical cancer is one of the most common malignant tumors in women, and more than one-third of the patients have already developed to a locally advanced stage at initial diagnosis. After standard concurrent chemoradiotherapy, recurrence still occurs in 29-38% of patients with locally advanced cervical cancer (LACC), and the 5-year survival rate of patients with recurrence is only 3.8-13.0%, resulting in a poor prognosis and limited therapeutic choices. Currently, the recommended first-line systemic treatment for recurrent metastatic cervical cancer involves cisplatin or carboplatin in combination with paclitaxel-based chemotherapy, supplemented with the antivascular agent bevacizumab and the immune checkpoint inhibitor pembrolizumab. The use of these drugs, however, is limited due to side effects such as myelosuppression, gastrointestinal perforation, and bleeding, so new treatment modalities need to be explored. Anti-EGFR (epithelial growth factor receptor, anti-surface growth factor receptor antibody) targeted drugs have been demonstrated to have a significant radiosensitizing effect on synchronous chemoradiotherapy in LACC and are now considered to have potential for the treatment of recurrent cervical cancer. We represented a LACC patient who relapsed 6 months after concurrent chemoradiotherapy. The patient received six cycles of nimotuzumab combined with camrelizumab, and the efficacy was evaluated to be partial remission after two or four cycles of treatment, with progression-free survival up to 9 months, without significant side effects. Until March 2024, the patient was still undergoing treatment. Promising efficacy and tolerable side effects of nimotuzumab in combination with camrelizumab were observed in this case.

摘要

宫颈癌是女性最常见的恶性肿瘤之一,超过三分之一的患者在初始诊断时已经发展到局部晚期。在标准的同期放化疗后,局部晚期宫颈癌(LACC)患者仍有 29-38%复发,复发患者的 5 年生存率仅为 3.8-13.0%,预后较差,治疗选择有限。目前,复发性转移性宫颈癌的推荐一线全身治疗包括顺铂或卡铂联合紫杉醇为基础的化疗,辅以抗血管生成药物贝伐珠单抗和免疫检查点抑制剂帕博利珠单抗。然而,由于骨髓抑制、胃肠道穿孔和出血等副作用,这些药物的使用受到限制,因此需要探索新的治疗方法。抗表皮生长因子受体(EGFR)(表皮生长因子受体,抗表面生长因子受体抗体)靶向药物已被证明在 LACC 的同步放化疗中具有显著的增敏作用,现在被认为具有治疗复发性宫颈癌的潜力。我们报告了一例 LACC 患者,该患者在同期放化疗后 6 个月复发。该患者接受了尼妥珠单抗联合卡瑞利珠单抗 6 个周期的治疗,在治疗 2 或 4 个周期后疗效评估为部分缓解,无进展生存期长达 9 个月,无明显不良反应。截至 2024 年 3 月,患者仍在接受治疗。尼妥珠单抗联合卡瑞利珠单抗在该病例中显示出了有希望的疗效和可耐受的副作用。

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