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在未知的原发性癌症中接受新辅助化学免疫治疗后,病理完整反应:一个病例报告

Ying-Long Peng^1,2,3, Hong-Yi Zhu^1,2,3, Hui-Bing Gao^1,2

¹Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.

Translational lung cancer research

|March 11, 2026

概括

新辅助化疗免疫疗法显示出治疗内转移的未知原发性癌症 (CUP) 的前景. 这种方法,结合多学科团队 (MDT) 指导和最小残留疾病 (MRD) 监测,可以改善患者的治疗结果.

科学领域:

在瘤学瘤学.
翻译医学是一种翻译医学.

背景情况:

未知原发性癌症 (CUP) 由于其异质性和预后不佳而构成重大临床挑战.
不知来源的胸内淋巴结转移特别难以管理,基于证据的治疗指南有限.
目前的分子导向疗法 (MGT) 提供了一些生存益处,但CUP的整体结果仍然不令人满意.

研究的目的:

介绍一个患有CUP和内淋巴结核病的患者的病例研究,该患者接受了新辅助化疗免疫治疗.
突出多学科团队 (MDT) 决策和最小残留疾病 (MRD) 监测在CUP管理中的作用.
在此背景下,评估新辅助药尼沃卢马布加上与专结合的帕克利塔塞尔和卡博普拉丁的疗效和安全性.

主要方法:

一名61岁的男性患有中枢淋巴结核病并没有可检测的原发性瘤,接受了下一代测序,揭示了TP53和RB1突变.
患者接受了三次新辅助药尼沃卢马布,与蛋白结合的帕克利塔塞尔和卡博普拉丁治疗,随后进行视频辅助胸腔镜手术.
使用循环瘤DNA (ctDNA) 进行最小残留疾病 (MRD) 监测.

主要成果:

患者在新辅助疗法和手术后实现了病理完整反应 (pCR),术后没有检测到可生存的瘤.
瘤标志物正常化,淋巴结代谢活性在新辅助治疗后降低.
连续ctDNAMRD监测仍然为阴性,患者在25.1个月的随访后没有出现复发,维持了良好的生活质量.

结论:

新辅助化疗免疫疗法对CUP患者具有胸内结节转移有益,即使初级瘤未被识别.
整合MDT共识和MRD监测可以为外科手术期间的策略提供信息,并可能优化CUP管理中的预后.
这个案例展示了成功的多式联运方法,用于具有挑战性的CUP呈现,实现持久的缓解.

关键词:

不知原发性癌症 (CUP) 的癌症.案例报告案例报告新辅助化学免疫治疗新辅助化学免疫治疗病理完整反应 (pCR) 是一种病理的完整反应.伪进步是一种伪进步.

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