Li Kevin Y, Lowy Andrew M, Fanta Paul
Department of Surgery, Division of Surgical Oncology, University of California, San Diego, San Diego, CA, United States.
Moores Cancer Center, University of California, San Diego, San Diego, CA, United States.
Front Immunol. 2024 Dec 2;15:1452543. doi: 10.3389/fimmu.2024.1452543. eCollection 2024.
The advent of checkpoint therapy is one of the most important recent advancements in cancer therapy. Though checkpoint therapy is a mainstay in some cancers, it has been largely ineffective in treating cancers of the pancreas. Pancreatic ductal adenocarcinoma and pancreatic neuroendocrine tumors are seldom responsive to checkpoint inhibition.
Here we present two cases of advanced pancreatic cancers that either failed to respond or recurred following conventional treatments. Tissue from each tumor was sequenced and analyzed for PD-L1 expression. Each patient was started on checkpoint blockade after assessing for a predictive biomarker, either the combined positive score or the tumor mutational burden. In each case, checkpoint blockade led to durable radiographic responses.
We therefore propose that it is reasonable to assess combined positive score and tumor mutational burden in refractory or recurrent pancreatic cancers when initiation of ICB is being considered.
检查点疗法的出现是癌症治疗领域近年来最重要的进展之一。尽管检查点疗法是某些癌症的主要治疗手段，但在治疗胰腺癌方面大多无效。胰腺导管腺癌和胰腺神经内分泌肿瘤很少对检查点抑制有反应。
我们在此展示两例晚期胰腺癌病例，这些病例在接受传统治疗后要么无反应，要么复发。对每个肿瘤的组织进行测序并分析程序性死亡受体配体1（PD-L1）表达情况。在评估预测性生物标志物（联合阳性评分或肿瘤突变负荷）后，每位患者开始接受检查点阻断治疗。在每种情况下，检查点阻断均导致持久的影像学反应。
因此，我们建议，在考虑开始免疫检查点阻断（ICB）治疗难治性或复发性胰腺癌时，评估联合阳性评分和肿瘤突变负荷是合理的。
