复发的微卫星不稳定性高胸腺癌显示对免疫检查点抑制剂的完全反应:一个病例报告
Tomoki Nakagawa1, Naohiro Aruga2, Hajime Watanabe1
1Department of Thoracic Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Oncology letters
|February 13, 2026
概括
本案例研究报告了第一个罕见的微观卫星不稳定性高胸膜癌 (MSI-H TC) 实现完全缓解的例子. 在接受免疫检查点抑制剂 (ICI) pembrolizumab治疗后,该患者经历了超过四年的持续恢复.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 遗传学 是一个遗传学.
背景情况:
- 微卫星高不稳定性 (MSI-H) 瘤是由DNA不匹配修复缺陷引起的,并且对免疫检查点抑制剂 (ICI) 有很好的反应.
- 胸膜癌 (TCs) 通常具有较低的体质突变和罕见的MSI-H发病率,使MSI-H TCs非常罕见.
- 编程死亡联体1 (PD-L1) 表达在TC中通常很高,但体突变率很低.
研究的目的:
- 报告 MSI-H 胸腺癌复发的第一个病例,该病例通过 pembrolizumab 单一治疗实现了完全缓解.
- 突出免疫检查点抑制剂 (ICI) 在罕见的MSI-H胸腺癌病例中的潜在疗效.
主要方法:
- 一名78岁的女性患者被诊断患有胸腺癌和肺转移,接受了瘤切除.
- 由于副作用,辅助化疗是有限的;随后的复发被用pembrolizumab作为二线治疗来治疗.
- 瘤组织遗传测试证实了微卫星的高不稳定性 (MSI-H) 状态.
主要成果:
- 患者在最初的手术4年9个月内实现了转移性病变的完全缓解.
- 在随访期间没有观察到复发,这表明对pembrolizumab的持续反应.
- 这代表了一个完整的反应,与以前报告的类似罕见病例中的部分反应有所区别.
结论:
- 这一案例证明了免疫检查点抑制剂 (ICI) 治疗的潜力,特别是 pembrolizumab,在复发性MSI-H胸腺癌的罕见病例中实现完全和持久的缓解.
- 需要进一步的研究来调查ICI在罕见MSI-H胸腺癌的更广泛人群中的有效性.
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