在患有尿路膀癌的患者的抗编程死亡-1疗法后的超级进展:病例报告
Hong-Yu Yang1,2, Yu-Xuan Du3, Yu-Jia Hou1
1Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100000, China.
World journal of clinical cases
|October 30, 2023
概括
免疫检查点抑制剂对泌尿器官癌 (UC) 是有前途的,但有些患者会出现超级进展. 这一案例凸显了需要仔细选择患者,并进一步研究晚期UC免疫疗法耐药性机制的需要.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 针对编程死亡连接体1 (PD-L1) 和编程死亡-1 (PD-1) 的免疫检查点抑制剂已被批准用于晚期泌尿腺癌 (UC).
- 一些患者矛盾地经历了瘤的快速进展 (超级进展),而不是从这些疗法中受益.
研究的目的:
- 在接受抗PD-L1药物治疗的晚期UC患者中呈现超级进展病例.
- 讨论选择免疫治疗患者的挑战以及生物标志物的需要.
主要方法:
- 一名73岁的患有转移性膀UC的女性患者,之前的化疗失败了,接受了toripalimab (抗PD-L1) 以及与专蛋白结合的帕克利塔塞尔.
- 下一代测序显示,瘤突变负担为6.4个突变/Mb.
主要成果:
- 患者在不到2个月的时间内经历了治疗失败,瘤负担增加了50%以上,进展率增加了2倍以上,与超级进展一致.
- 瘤突变负担为6.4个突变/Mb.
结论:
- 在晚期UC中选择免疫治疗的患者仍然具有挑战性,特别是在治疗选择有限的老年患者中.
- 在没有预测生物标志物的这种人群中,应谨慎使用免疫疗法.
- 需要进一步的研究,以了解驱动超级进展的机制.
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