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一名患有严重自身免疫性疾病的肺癌患者化疗失败后接受四线免疫治疗实现完全缓解:肿瘤治疗中的意外转折

Complete Remission With Fourth-Line Immunotherapy After Chemotherapy Failure in a Lung Cancer Patient With Severe Autoimmune Disease: An Unexpected Turn in Oncologic Management.

作者信息

Herrero Rivera Daniel, Soriano Segura María, Prato Varela Javier Orlando, Brygadyr Medvid Yaroslav, López Martín José Antonio

机构信息

Medical Oncology, HLA Moncloa University Hospital/ATRYS Health, Madrid, ESP.

Medicine, European University of Madrid, Madrid, ESP.

出版信息

Cureus. 2025 Jun 16;17(6):e86116. doi: 10.7759/cureus.86116. eCollection 2025 Jun.

Abstract

The indication for nivolumab in patients with advanced non-small cell lung cancer (NSCLC) who have progressed to first-line platinum-based systemic therapy was one of the first indications for immunotherapy approved by regulatory agencies. However, it is generally the case that patients with autoimmune diseases (AIDs) are excluded from studies due to the risk of immune exacerbations and a higher rate of immune-related adverse effects. This deprives these patients of the potential benefits they could obtain from immunotherapy, especially in those cases with favorable biomarkers of a good response. In this study, we present a clinical case of a patient with rapidly progressive multiple sclerosis (MS) of years of evolution, who obtained an impressive response to immunotherapy as a last therapeutic option, remaining cancer-free to date.

摘要

纳武利尤单抗用于一线铂类全身治疗后进展的晚期非小细胞肺癌(NSCLC)患者,是监管机构批准的首批免疫治疗适应证之一。然而,由于存在免疫反应加重的风险以及免疫相关不良反应发生率较高,自身免疫性疾病(AIDs)患者通常被排除在研究之外。这使这些患者无法获得免疫治疗可能带来的益处,尤其是在那些具有良好反应生物标志物的病例中。在本研究中,我们报告了一例多年来快速进展的多发性硬化症(MS)患者的临床病例,该患者作为最后的治疗选择接受免疫治疗后获得了显著疗效,至今无癌生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ac/12265009/04878713e5c0/cureus-0017-00000086116-i01.jpg

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