Matsumura Yugo, Ichihara Seiya, Nii Kaori, Nanjo Kazumasa, Kadota Naoki, Okano Yoshio, Machida Hisanori, Hatakeyama Nobuo, Hino Hiroyuki, Naruse Keishi, Shinohara Tsutomu, Sakiyama Shoji, Takeuchi Eiji
Department of Respiratory Medicine, National Hospital Organization Kochi Hospital, Kochi City, Kochi, Japan.
Department of Thoracic Surgery, National Hospital Organization Kochi Hospital, Kochi City, Kochi, Japan.
Thorac Cancer. 2025 Jan;16(2):e15519. doi: 10.1111/1759-7714.15519. Epub 2024 Dec 17.
We herein describe a patient with non-small-cell lung cancer who achieved pCR with a single dose of pembrolizumab-based chemoimmunotherapy followed by surgery. A 61-year-old man was referred to our hospital with wheezing and an abnormal chest shadow. Squamous cell carcinoma of the left lower lobe, cT2aN1M0 stage IIB, was diagnosed and pembrolizumab-based chemoimmunotherapy was initiated at the patient's request. One month later, chest CT revealed new ground-glass opacities of the lungs, which were judged to be a CTCAE grade 2 pneumonitis due to an immune-related adverse event (irAE). Therefore, steroid therapy was initiated. Prednisolone was tapered and discontinued as symptoms improved. A sleeve resection of the left lower lobe was performed, and a pathological complete response (pCR) was confirmed in a resected specimen. There has been no recurrence for 1 year and 7 months without treatment. This is the first case report of pCR to a single dose of chemoimmunotherapy followed by surgery for lung cancer. The present results suggest the potential of a single dose of chemoimmunotherapy to achieve pCR and cause irAEs in some patients.
我们在此描述了一名非小细胞肺癌患者，其接受单剂量基于帕博利珠单抗的化疗免疫治疗后达到病理完全缓解（pCR），随后接受了手术。一名61岁男性因喘息和胸部阴影异常转诊至我院。诊断为左肺下叶鳞状细胞癌，cT2aN1M0 IIB期，应患者要求开始基于帕博利珠单抗的化疗免疫治疗。1个月后，胸部CT显示肺部出现新的磨玻璃影，因免疫相关不良事件（irAE）被判定为CTCAE 2级肺炎。因此，开始使用类固醇治疗。随着症状改善，泼尼松逐渐减量并停药。对左肺下叶进行了袖状切除术，切除标本中证实为病理完全缓解（pCR）。未经治疗1年7个月无复发。这是首例单剂量化疗免疫治疗后手术治疗肺癌达到pCR的病例报告。目前的结果表明，单剂量化疗免疫治疗在某些患者中具有实现pCR并引起irAE的潜力。
