对于最初无法切除的MSI-H小肠腺癌,pembrolizumab后的转化手术:病例报告和简要分析
Yu Nakashima1, Yukihiro Yokoyama2, Kazuhiro Hiramatsu1
1Department of General Surgery, Toyohashi Municipal Hospital, Toyohashi, Japan.
Immunotherapy
|February 5, 2026
概括
这项案例研究表明,布罗利祖马布可以帮助手术切除晚期小肠腺癌 (SBA). 一名患有微卫星不稳定性高 (MSI-H) 的SBA患者对免疫疗法反应良好,使得治疗性手术成为可能.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 小肠腺癌 (SBA) 是一种罕见的癌症,通常是晚诊断的.
- 局部先进的不可切除的SBA带来了重大的治疗挑战.
研究的目的:
- 报告一个成功的转换手术的案例,用于使用 pembrolizumab. unresectable 阴SBA 使用 pembrolizumab.
- 在MSI-H SBA中评估免疫检查点抑制剂的疗效.
主要方法:
- 一名患有晚期阴SBA的患者接受了FOLFOX化疗,然后在识别MSI高状态时切换到pembrolizumab.
- 通过成像评估反应,然后进行转换手术 (带有淋巴切除术的部分结核切除术).
- 进行了对10项用ICI治疗的MSI-H/dMMR SBA研究的元分析.
主要成果:
- 布罗利祖马布治疗导致转移性淋巴结的显著回归,使R0切除.
- 病理学证实了广泛纤维化患者对免疫治疗的显著反应.
- 分析显示,MSI-H/dMMR SBA中ICI的客观响应率为65.3%.
结论:
- 布罗利祖马布可以在最初无法切除的MSI-H SBA中促进治愈切除.
- 免疫疗法是高级SBA的有希望的策略,特别是在MSI-H病例中.
- 这种方法可能会改善这种罕见恶性瘤患者的治疗结果.
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