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病例报告:免疫治疗的显著疗效:信迪利单抗联合安罗替尼治疗化疗耐药的晚期肺肉瘤样癌患者的显著疗效。

Case report: A golden tail of immunotherapy: significant tail effect in a chemotherapy-resistant advanced pulmonary sarcomatoid carcinoma patient treated by Sintilimab combined with Anlotinib.

机构信息

Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

出版信息

Front Immunol. 2024 Nov 6;15:1452195. doi: 10.3389/fimmu.2024.1452195. eCollection 2024.

DOI:10.3389/fimmu.2024.1452195
PMID:39569200
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11576465/
Abstract

Tail effect is a unique phenomenon in immunotherapy characterized by the prolonged maintenance of therapeutic efficacy. It can be observable even after treatment cessation. Immunotherapy has gradually become a vital regimen for the treatment of advanced lung cancer patients, among which immune-combined therapies based on immune checkpoint inhibitors (ICIs) have been applied clinically and demonstrates considerable clinical efficacy. In this case report, the patient was pathologically diagnosed with pulmonary sarcomatoid carcinoma (PSC), a rare and highly aggressive subtype of non-small cell lung cancer (NSCLC) known for its poor prognosis due to high invasiveness and metastatic potential. After developing resistance to chemotherapy, the patient was treated with a combined regimen of sintilimab and anlotinib, leading to initial clinical improvement. Following just three cycles of this regimen, treatment was discontinued, and the patient was discharged. Remarkably, over the subsequent months, the patient exhibited a significant tail effect, evidenced by sustained therapeutic stability, continuous tumor regression, stable low levels of serum carcinoembryonic antigen (CEA), and further improvement in clinical symptoms. Tail effect is a golden tail of immunotherapy. This case illustrates that the tail effect of immunotherapy can offer substantial survival benefits for patients with unresectable advanced lung cancer who have failed chemotherapy.

摘要

尾效应是免疫治疗中的一个独特现象,其特征是治疗效果的持久维持。即使在治疗停止后,也可以观察到这种效应。免疫疗法已逐渐成为治疗晚期肺癌患者的重要方案,其中基于免疫检查点抑制剂(ICI)的免疫联合疗法已在临床上得到应用,并显示出相当的临床疗效。在本病例报告中,患者经病理诊断为肺肉瘤样癌(PSC),这是一种罕见且高度侵袭性的非小细胞肺癌(NSCLC)亚型,由于高侵袭性和转移性潜能,预后较差。在对化疗产生耐药性后,患者接受了信迪利单抗联合安罗替尼的联合治疗方案,最初临床情况有所改善。仅仅进行了三个周期的治疗后,就停止了治疗并安排患者出院。值得注意的是,在随后的几个月里,患者表现出显著的尾效应,表现为持续的治疗稳定性、肿瘤持续消退、血清癌胚抗原(CEA)水平稳定较低,以及临床症状进一步改善。尾效应是免疫治疗的一个金色尾巴。本病例表明,对于化疗失败的不可切除的晚期肺癌患者,免疫治疗的尾效应可以为其提供显著的生存获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/7d70fea9e38e/fimmu-15-1452195-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/31012369d7c8/fimmu-15-1452195-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/9b8c8279049a/fimmu-15-1452195-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/d9043be157aa/fimmu-15-1452195-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/7d70fea9e38e/fimmu-15-1452195-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/31012369d7c8/fimmu-15-1452195-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/9b8c8279049a/fimmu-15-1452195-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/d9043be157aa/fimmu-15-1452195-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c0/11576465/7d70fea9e38e/fimmu-15-1452195-g004.jpg

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