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口腔未分化癌序贯免疫联合靶向治疗后发生肉瘤样癌转化：1 例报告。

Sarcomatoid carcinoma transformation in oral undifferentiated carcinoma following sequential immune combined targeted therapy: a case report.

机构信息

Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

School of Stomatology, Qingdao University, Qingdao, Shandong, China.

出版信息

Front Immunol. 2024 Oct 24;15:1484915. doi: 10.3389/fimmu.2024.1484915. eCollection 2024.

DOI:10.3389/fimmu.2024.1484915
PMID:39512346
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11540681/
Abstract

The diagnosis and treatment of head and neck undifferentiated carcinoma (HNUC) present significant challenges. Herein, we present the case of a patient with advanced HNUC who underwent conversion surgery following treatment with a combination of pembrolizumab and nimotuzumab. During therapy, histological transformation from undifferentiated to sarcomatoid carcinoma was detected at the primary site. This case not only highlights the potential of immune combination-targeted therapy to reduce tumour burden and increase the surgical options for patients, but also reveals the complex alterations in tumour biology that may occur during treatment. It emphasizes the necessity for routine pathological assessments throughout the therapeutic regimen to guide personalised therapeutic strategies and optimise patient prognoses.

摘要

头颈部未分化癌（HNUC）的诊断和治疗存在很大的挑战。本文报道了一例接受帕博利珠单抗联合尼妥珠单抗治疗后转化为肉瘤样癌的晚期 HNUC 患者，行转化性手术的病例。在治疗过程中，原发部位的组织学检测到未分化向肉瘤样癌的转化。本病例不仅突出了免疫联合靶向治疗降低肿瘤负荷并增加手术选择的潜力，还揭示了治疗过程中肿瘤生物学可能发生的复杂变化。它强调了在整个治疗过程中进行常规病理评估以指导个体化治疗策略和优化患者预后的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/1dee6f56800b/fimmu-15-1484915-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/bc55de6cf998/fimmu-15-1484915-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/211402b71ec4/fimmu-15-1484915-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/bb59c099bd0f/fimmu-15-1484915-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/1dee6f56800b/fimmu-15-1484915-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/bc55de6cf998/fimmu-15-1484915-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/211402b71ec4/fimmu-15-1484915-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/bb59c099bd0f/fimmu-15-1484915-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87c6/11540681/1dee6f56800b/fimmu-15-1484915-g004.jpg

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本文引用的文献

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Ther Adv Med Oncol. 2024 Mar 6;16:17588359241236450. doi: 10.1177/17588359241236450. eCollection 2024.
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Granulation tissue-like spindle cell (sarcomatoid) carcinoma of the head and neck: a deceptively bland-looking underdiagnosed malignancy.头颈部类肉芽组织梭形细胞（肉瘤样）癌：一种具有欺骗性的、外观温和但易被漏诊的恶性肿瘤。
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表皮生长因子受体突变型肺腺癌转化为肉瘤的临床分析
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Efficacy and Safety of Pembrolizumab Monotherapy for Recurrent/Unresectable/Metastatic Oral Squamous Cell Carcinoma: A Single-Center Study in China.帕博利珠单抗单药治疗复发性/不可切除/转移性口腔鳞状细胞癌的疗效和安全性：一项中国单中心研究
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Transformation or tumor heterogeneity: Mutations in EGFR, SOX2, TP53, and RB1 persist in the histological rapid conversion from lung adenocarcinoma to small-cell lung cancer.从肺腺癌到小细胞肺癌的组织学快速转化中，EGFR、SOX2、TP53 和 RB1 中的突变持续存在，提示转化或肿瘤异质性。
Thorac Cancer. 2023 Apr;14(11):1036-1041. doi: 10.1111/1759-7714.14832. Epub 2023 Feb 21.
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