肺腺癌患者在Atezolizumab治疗过程中出现假性进展的案例报道
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摘要
肺癌是全球癌症相关死亡的最常见原因。根据病理类型的不同,肺癌可分为非小细胞肺癌(non-small cell lung cancer, NSCLC)和小细胞肺癌(small cell lung cancer, SCLC)。其中NSCLC约占所有肺癌患者的85%。免疫检查点抑制剂(immune checkpoint inhibitors, ICIPs)是一类针对程序性死亡受体-1(programmed cell death protein 1, PD-1)及其配体(programmed death-ligand 1, PD-L1)的抑制剂,已有研究结果显示ICIPs在许多不同的癌症中具有良好且持久的抗癌疗效,其中抗PD-L1单克隆抗体Atezolizumab(MPDL3280)正在实体瘤和恶性血液病中开展临床研究。据报道,假性进展是免疫治疗中可能出现的独特现象之一。本文中我们报道了1例晚期NSCLC接受免疫治疗后发生假性进展的病例,希望这一案例可以更好地帮助临床医生恰当评估免疫治疗的疗效,并作出最恰当的治疗决策。
Lung cancer is the most common cause of cancer-related death worldwide. There are two classes of lung cancer: non-small cell lung cancer(NSCLC) and small cell lung cancer(SCLC). NSCLC represents approximately 85% of all lung cancer cases. Immune checkpoint inhibitors(ICIPs) are a class of inhibitors of programmed death-1 and programmed death-ligand 1. Preclinical studies have shown that ICIPs have shown good clinical efficacy and durable response in diverse cancers. Among them, atezolizumab(MPDL3280), an anti-PD-L1 monoclonal antibody, is being investigated as a potential therapy against solid tumors and hematologic malignancies in humans. Pseudoprogression is reported as one of the unique phenomena with immune therapeutic agents. Here we report case of a person with advanced NSCLC who developed pseudoprogression after receiving immunotherapy. We hope this case could help clinicians to make appropriate decision when assessing therapeutic effects of immunotherapy.
Lung cancer is the most common cause of cancer-related death worldwide. There are two classes of lung cancer: non-small cell lung cancer(NSCLC) and small cell lung cancer(SCLC). NSCLC represents approximately 85% of all lung cancer cases. Immune checkpoint inhibitors(ICIPs) are a class of inhibitors of programmed death-1 and programmed death-ligand 1. Preclinical studies have shown that ICIPs have shown good clinical efficacy and durable response in diverse cancers. Among them, atezolizumab(MPDL3280), an anti-PD-L1 monoclonal antibody, is being investigated as a potential therapy against solid tumors and hematologic malignancies in humans. Pseudoprogression is reported as one of the unique phenomena with immune therapeutic agents. Here we report case of a person with advanced NSCLC who developed pseudoprogression after receiving immunotherapy. We hope this case could help clinicians to make appropriate decision when assessing therapeutic effects of immunotherapy.
引文
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2 Printz C.Nivolumab improves survival for patients with advanced lung cancer.Cancer,2017,123(17):3211.doi:10.1002/cncr.30930
3 Shamai S,Mer imsky O.Efficacy and safet y of Nivolumab in non-small cell lung cancer patients in Tel-Aviv tertiary medical center:Facing the reality.Mol Clin Oncol,2018,9(4):419-422.doi:10.3892/mco.2018.1693
4 Di Giacomo AM,Daniel li R,Guidoboni M,et al.Therapeutic ef f icacy of ipilimumab,an anti-CTLA-4 monoclonal antibody,in patients with metastatic melanoma unresponsive to prior systemic treatments:clinical and immunological evidence f rom three pat ient cases.Cancer Immunol Immunother,2009,58(8):1297-1306.doi:10.1007/s00262-008-0642-y
5 Cohen JV,Alomari AK,Vortmeyer AO,et al.Melanoma brain metastasis pseudoprogression after pembrolizumab treatment.Cancer Immunol Res,2016,4(3):179-182.doi:10.1158/2326-6066.cir-15-0160
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7 Wolchok JD,Hoos A,O’day S,et al.Guidelines for the evaluation of immune therapy activity in solid tumors:immunerelated response criteria.Clin Cancer Res,2009,15(23):7412-7420.doi:10.1158/1078-0432.ccr-09-1624
8 Chiou VL,Burotto M.Pseudoprogression and immunerelated response in solid tumors.J Clin Oncol,2015,33(31):3541-3543.doi:10.1200/jco.2015.61.6870
9 Hanahan D,Weinberg RA.Hallmarks of cancer:the next generation.Cell,2011,144(5):646-674.doi:10.1016/j.cell.2011.02.013
10 Yamaura T,Suzuki H.Pseudoprogression and rapid response to pembrolizumab in a patient with advanced lung adenocarcinoma with loss of epidermal growth factor receptor gene mutation after tyrosine kinase inhibitor therapy.J Thorac Oncol,2018,13(10):e209-e210.doi:10.1016/j.jtho.2018.05.021
11 Melian M,Lorente D,Aparici F,et al.Lung brain metastasis pseudoprogression after nivolumab and ipilimumab combination treatment.Thorac Cancer,2018,9(12):1770-1773.doi:10.1111/1759-7714.12873
12 Swami U,Smith M,Zhang J.Central nervous system pseudoprogression with nivolumab in a patient with squamous cell lung cancer followed by prolonged response.JThorac Oncol,2018,13(9):e183-e184.doi:10.1016/j.jtho.2018.05.001
13 Rocha P,Hardy-Werbin M,Naranjo D,et al.CD103+CD8+lymphocytes characterize the immune infiltration in a case with pseudoprogression in squamous NSCLC.J Thorac Oncol,2018,13(10):e193-e196.doi:10.1016/j.jtho.2018.05.008
14 Curioni-Fontecedro A,Ickenberg C,Franzen D,et al.Diffuse pseudoprogression in a p-atient with metastatic nonsmallcell lung cancer treated with Nivolumab.Ann Oncol,2017,28(8):2040-2041.doi:10.1093/annonc/mdx233
15 Liu G,Chen T,Li R,et al.Well-controlled pleural effusion indicated pseudoprogression a-fter immunotherapy in lung cancer:A case report.Thorac Cancer,2018,9(9):1190-1193.doi:10.1111/1759-7714.12799
2 Printz C.Nivolumab improves survival for patients with advanced lung cancer.Cancer,2017,123(17):3211.doi:10.1002/cncr.30930
3 Shamai S,Mer imsky O.Efficacy and safet y of Nivolumab in non-small cell lung cancer patients in Tel-Aviv tertiary medical center:Facing the reality.Mol Clin Oncol,2018,9(4):419-422.doi:10.3892/mco.2018.1693
4 Di Giacomo AM,Daniel li R,Guidoboni M,et al.Therapeutic ef f icacy of ipilimumab,an anti-CTLA-4 monoclonal antibody,in patients with metastatic melanoma unresponsive to prior systemic treatments:clinical and immunological evidence f rom three pat ient cases.Cancer Immunol Immunother,2009,58(8):1297-1306.doi:10.1007/s00262-008-0642-y
5 Cohen JV,Alomari AK,Vortmeyer AO,et al.Melanoma brain metastasis pseudoprogression after pembrolizumab treatment.Cancer Immunol Res,2016,4(3):179-182.doi:10.1158/2326-6066.cir-15-0160
6 Kazandjian D,Keegan P,Suzman DL,et al.Characterization of outcomes in patients with metastatic non-small cell lung cancer treated with programmed cell death protein 1inhibitors past RECIST version 1.1-defined disease progression in clinical trials.Semin Oncol,2017,44(1):3-7.doi:10.1053/j.seminoncol.2017.01.001
7 Wolchok JD,Hoos A,O’day S,et al.Guidelines for the evaluation of immune therapy activity in solid tumors:immunerelated response criteria.Clin Cancer Res,2009,15(23):7412-7420.doi:10.1158/1078-0432.ccr-09-1624
8 Chiou VL,Burotto M.Pseudoprogression and immunerelated response in solid tumors.J Clin Oncol,2015,33(31):3541-3543.doi:10.1200/jco.2015.61.6870
9 Hanahan D,Weinberg RA.Hallmarks of cancer:the next generation.Cell,2011,144(5):646-674.doi:10.1016/j.cell.2011.02.013
10 Yamaura T,Suzuki H.Pseudoprogression and rapid response to pembrolizumab in a patient with advanced lung adenocarcinoma with loss of epidermal growth factor receptor gene mutation after tyrosine kinase inhibitor therapy.J Thorac Oncol,2018,13(10):e209-e210.doi:10.1016/j.jtho.2018.05.021
11 Melian M,Lorente D,Aparici F,et al.Lung brain metastasis pseudoprogression after nivolumab and ipilimumab combination treatment.Thorac Cancer,2018,9(12):1770-1773.doi:10.1111/1759-7714.12873
12 Swami U,Smith M,Zhang J.Central nervous system pseudoprogression with nivolumab in a patient with squamous cell lung cancer followed by prolonged response.JThorac Oncol,2018,13(9):e183-e184.doi:10.1016/j.jtho.2018.05.001
13 Rocha P,Hardy-Werbin M,Naranjo D,et al.CD103+CD8+lymphocytes characterize the immune infiltration in a case with pseudoprogression in squamous NSCLC.J Thorac Oncol,2018,13(10):e193-e196.doi:10.1016/j.jtho.2018.05.008
14 Curioni-Fontecedro A,Ickenberg C,Franzen D,et al.Diffuse pseudoprogression in a p-atient with metastatic nonsmallcell lung cancer treated with Nivolumab.Ann Oncol,2017,28(8):2040-2041.doi:10.1093/annonc/mdx233
15 Liu G,Chen T,Li R,et al.Well-controlled pleural effusion indicated pseudoprogression a-fter immunotherapy in lung cancer:A case report.Thorac Cancer,2018,9(9):1190-1193.doi:10.1111/1759-7714.12799