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病例报告:针对肠分化,EGFR突变和高微卫星不稳定的肺腺癌的向和免疫治疗

Meiling Yang¹, Pengli Yu², Zhiyi He¹

¹Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Frontiers in immunology

|February 9, 2024

概括

肺肠腺癌 (PEAC) 是一种罕见的肺癌. 这种病例突出了一个患有PEAC,EGFR突变和MSI-H的患者,他们对EGFR抑制剂有反应,但没有免疫治疗.

科学领域:

在瘤学瘤学.
基因组学就是基因组学.
病理学病理学病理学

背景情况:

肺肠腺癌 (PEAC) 是一种罕见的非小细胞肺癌 (NSCLC) 亚型,具有显著的肠道分化特征.
高微卫星不稳定性 (MSI-H) 很少在肺癌中观察到.
在PEAC中,标准NSCLC治疗,如EGFR氨酸激酶抑制剂 (TKI) 和免疫治疗的疗效在很大程度上仍未确定.

研究的目的:

报告一个具有EGFR突变和MSI-H并发的PEAC病例.
描述这种独特患者的临床过程和治疗反应.
为了解罕见肺腺癌亚型的治疗策略做出贡献.

主要方法:

肺部活检和内镜样本用于肠道分化的组织病理学分析.
对基因突变 (EGFR,T790M) 和微卫星不稳定性 (MSI-H) 的下一代测序 (NGS).
针对不匹配修复 (MMR) 蛋白质表达的免疫组织化学测定.

主要成果:

诊断为转移性肺腺癌的患者被发现患有EGFR E19del,T790M和MSI-H.
以EGFR TKI (icotinib) 进行初始治疗后,其次是奥西默提尼布,导致短暂的无进展生存期 (PFS) 为3个月.
随后的治疗包括化疗,贝瓦齐祖马布和免疫疗法 (camrelizumab) 显示出有限的疗效,患者经历疾病进展和感染.
总体生存时间为30个月.

结论:

这种病例呈现出一种罕见的肺肠腺癌,其中包括EGFR激活突变和MSI-H.
患者对EGFR TKIs表现出反应,但对免疫检查点抑制剂的效果不佳.
需要进一步的研究来优化复杂分子形状的PEAC的治疗范式.

关键词:

欧洲农业基金会 (EGFR) 是一个基金.在MSI-H中,您可以使用MSI-H.免疫检查点抑制剂免疫检查点抑制剂在 pMMR 中,pMMR 是 pMMR.肺部肠道腺癌细胞瘤.

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