Ninomaru Taira, Yoshimura Sho, Mukaida Satoshi, Matsuo Kenjiro, Kimura Yohei, Nakai Tokiko
Respiratory Medicine, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, JPN.
Pathology, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, JPN.
Cureus. 2025 Apr 9;17(4):e81973. doi: 10.7759/cureus.81973. eCollection 2025 Apr.
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) is the standard treatment for -mutated non-small cell lung cancer (NSCLC), although a small subset of patients does not respond to EGFR-TKI, especially in patients with a smoking history and squamous cell histology. Additionally, even given an initial good response, acquired resistance to EGFR-TKI is inevitable. More individualized treatment could be necessary in certain types of -mutated NSCLC. We herein report a case of -mutated metastatic lung squamous cell carcinoma with a high tumor proportion score (TPS) of programmed death ligand 1 (PD-L1), where chemotherapy plus pembrolizumab therapy had a durable efficacy. In this case, chemotherapy plus pembrolizumab therapy was administered, though EGFR-TKI is the standard first-line therapy of -mutated NSCLC. Three years after treatment initiation, no sign of recurrence was observed. This case suggests that a detailed evaluation of a patient's background is important in making an effective personalized therapeutic strategy.
表皮生长因子受体（EGFR）-酪氨酸激酶抑制剂（TKI）是治疗EGFR突变型非小细胞肺癌（NSCLC）的标准疗法，不过有一小部分患者对EGFR-TKI无反应，尤其是有吸烟史和鳞状细胞组织学特征的患者。此外，即便最初反应良好，EGFR-TKI获得性耐药也不可避免。对于某些类型的EGFR突变型NSCLC，可能需要更个体化的治疗。我们在此报告一例EGFR突变型转移性肺鳞状细胞癌病例，其程序性死亡配体1（PD-L1）的肿瘤比例评分（TPS）较高，化疗联合派姆单抗治疗具有持久疗效。在该病例中，尽管EGFR-TKI是EGFR突变型NSCLC的标准一线治疗方案，但仍采用了化疗联合派姆单抗治疗。治疗开始三年后，未观察到复发迹象。该病例表明，对患者背景进行详细评估对于制定有效的个性化治疗策略很重要。
