国际肿瘤学杂志››2023,Vol. 50››Issue (7): 445-448.doi:10.3760/cma.j.cn371439-20230208-00086
• 病例报道 •上一篇
收稿日期:
2023-02-08修回日期:
2023-06-07出版日期:
2023-07-08发布日期:
2023-08-03通讯作者:
张梅,Email:
Received:
2023-02-08Revised:
2023-06-07Online:
2023-07-08Published:
2023-08-03摘要:
近年来,免疫治疗在转移性肾癌的治疗领域中取得了突破性进展,是目前晚期肾癌综合治疗体系中重要的组成部分。现报道1例右肾透明细胞癌根治术后出现双肺多发转移患者,一线使用培唑帕尼治疗进展,二线使用帕博利珠单抗联合阿昔替尼出现免疫检查点抑制剂相关性肺炎,经激素冲击治疗好转后,改用恩沃利单抗联合阿昔替尼治疗持续获益,以期为临床使用免疫治疗提供参考。
陈秋, 王雷, 王明琦, 张梅. 恩沃利单抗联合阿昔替尼治疗肾癌肺转移1例并文献复习[J]. 国际肿瘤学杂志, 2023, 50(7): 445-448.
图1
1例肾癌术后双肺多发转移患者使用恩沃利单抗联合阿昔替尼治疗前后肺部CT图像 A~C为肾癌术后发现肺转移,一线使用培唑帕尼治疗4个月余,转移灶进展肺部CT图像,A为左肺上叶转移灶,B为右侧肺门部转移灶,C为右肺中叶转移灶,最大长径约32.2 mm;D~F为二线使用帕博利珠单抗联合阿昔替尼治疗14 d后出现免疫检查点抑制剂相关性肺炎后肺部CT图像,D为左肺上叶转移灶,E为右侧肺门部转移灶,有部分纤维索条影改变,F为右肺中下叶转移灶较前增大,且呈现高密度影改变,最大长径约34.1 mm;G~I为恩沃利单抗联合阿昔替尼治疗6个周期后肺部CT图像,G为左肺上叶转移灶,H为右侧肺门部转移灶,I为右肺中叶转移灶,最大长径约8.26 mm"
[1] | 中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)免疫检查点抑制剂相关的毒性管理指南2021[M]. 北京: 人民卫生出版社, 2021: 70-75. |
[2] | 武玲, 武晓旭, 冯慧晶, 等. 信迪利单抗联合IBI310治疗恶性黑色素瘤致重症免疫相关性心肌炎一例及文献分析[J]. 中国肿瘤生物治疗杂志, 2022, 29(11): 1013-1016. DOI: 10.3872/j.issn.1007-385x.2022.11.010. doi:10.3872/j.issn.1007-385x.2022.11.010 |
[3] | Wang DY, Salem JE, Cohen JV, et al. Fatal toxic effects associated with immune checkpoint inhibitors: a systematic review and meta-analysis[J]. JAMA Oncol, 2018, 4(12): 1721-1728. DOI: 10.1001/jamaoncol.2018.3923. doi:10.1001/jamaoncol.2018.3923pmid:30242316 |
[4] | Bukamur H, Katz H, Alsharedi M, et al. Immune checkpoint inhibitor-related pulmonary toxicity: focus on nivolumab[J]. South Med J, 2020, 113(11): 600-605. DOI: 10.14423/SMJ.0000000000001166. doi:10.14423/SMJ.0000000000001166pmid:33140115 |
[5] | Su Q, Zhu EC, Wu JB, et al. Risk of pneumonitis and pneumonia associated with immune checkpoint inhibitors for solid tumors: a systematic review and meta-analysis[J]. Front Immunol, 2019, 10: 108. DOI: 10.3389/fimmu.2019.00108. doi:10.3389/fimmu.2019.00108pmid:30778352 |
[6] | Sears CR, Peikert T, Possick JD, et al. Knowledge gaps and research priorities in immune checkpoint inhibitor-related pneumonitis. An official American Thoracic Society research statement[J]. Am J Respir Crit Care Med, 2019, 200(6): e31-e43. DOI: 10.1164/rccm.201906-1202ST. doi:10.1164/rccm.201906-1202ST |
[7] | Nishino M, Ramaiya NH, Awad MM, et al. PD-1 inhibitor-related pneumonitis in advanced cancer patients: radiographic patterns and clinical course[J]. Clin Cancer Res, 2016, 22(24): 6051-6060. DOI: 10.1158/1078-0432.CCR-16-1320. doi:10.1158/1078-0432.CCR-16-1320pmid:27535979 |
[8] | Postow MA, Sidlow R, Hellmann MD. Immune-related adverse events associated with immune checkpoint blockade[J]. N Engl J Med, 2018, 378(2): 158-168. DOI: 10.1056/NEJMra1703481. doi:10.1056/NEJMra1703481 |
[9] | Zhai X, Zhang J, Tian Y, et al. The mechanism and risk factors for immune checkpoint inhibitor pneumonitis in non-small cell lung cancer patients[J]. Cancer Biol Med, 2020, 17(3): 599-611. DOI: 10.20892/j.issn.2095-3941.2020.0102. doi:10.20892/j.issn.2095-3941.2020.0102pmid:32944393 |
[10] | 陈双庆, 吴文博, 韩朝辉, 等. 免疫检查点抑制剂相关肺炎研究进展[J]. 肿瘤防治研究, 2022, 49(10): 1065-1070. DOI: 10.3971/j.issn.1000-8578.2022.22.0145. doi:10.3971/j.issn.1000-8578.2022.22.0145 |
[11] | Li H, Ma W, Yoneda KY, et al. Severe nivolumab-induced pneumonitis preceding durable clinical remission in a patient with refractory, metastatic lung squamous cell cancer: a case report[J]. J Hematol Oncol, 2017, 10(1): 64. DOI: 10.1186/s13045-017-0433-z. doi:10.1186/s13045-017-0433-z |
[12] | Dolladille C, Ederhy S, Sassier M, et al. Immune checkpoint inhibitor rechallenge after immune-related adverse events in patients with cancer[J]. JAMA Oncol, 2020, 6(6): 865-871. DOI: 10.1001/jamaoncol.2020.0726. doi:10.1001/jamaoncol.2020.0726pmid:32297899 |
[13] | 段林立, 金川, 陈嵘, 等. 免疫检查点抑制剂相关肺炎22例临床特征分析[J]. 广州医科大学学报, 2022, 50(5): 12-18. DOI: 10.3969/j.issn.2095-9664.2022.05.03. doi:10.3969/j.issn.2095-9664.2022.05.03 |
[14] | Menzies AM, Johnson DB, Ramanujam S, et al. Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab[J]. Ann Oncol, 2017, 28(2): 368-376. DOI: 10.1093/annonc/mdw443. doi:10.1093/annonc/mdw443pmid:27687304 |
[15] | Baxi S, Yang A, Gennarelli RL, et al. Immune-related adverse events for anti-PD-1 and anti-PD-L1 drugs: systematic review and meta-analysis[J]. BMJ, 2018, 360: k793. DOI: 10.1136/bmj.k793. doi:10.1136/bmj.k793 |
[16] | Pérol M. Multidisciplinary approach of immune checkpoint inhibitor-related pneumonitis: a key to address knowledge and management gaps[J]. J Thorac Oncol, 2020, 15(8): 1261-1264. DOI: 10.1016/j.jtho.2020.05.007. doi:S1556-0864(20)30393-2pmid:32718532 |
[17] | Pillai RN, Behera M, Owonikoko TK, et al. Comparison of the toxicity profile of PD-1 versus PD-L1 inhibitors in non-small cell lung cancer: a systematic analysis of the literature[J]. Cancer, 2018, 124(2): 271-277. DOI: 10.1002/cncr.31043. doi:10.1002/cncr.31043pmid:28960263 |
[18] | Markham A. Envafolimab: first approval[J]. Drugs, 2022, 82(2): 235-240. DOI: 10.1007/s40265-022-01671-w. doi:10.1007/s40265-022-01671-wpmid:35122636 |
[19] | Xu JM, Papadopoulos KP, Shimizu T, et al. Efficacy of envafolimab, a novel subcutaneous anti-PD-L1 inhibitor, in patients with advanced solid tumors: pooled results from three phase Ⅰ studies[C]. 2022 CSCO学术年会论文汇编, 北京: 中国临床肿瘤学会, 2022: 87-88. |
[20] | Motzer RJ, Escudier B, Tomczak P, et al. Axitinib versus sorafenib as second-line treatment for advanced renal cell carcinoma: overall survival analysis and updated results from a randomised phase 3 trial[J]. Lancet Oncol, 2013, 14(6): 552-562. DOI: 10.1016/S1470-2045(13)70093-7. doi:10.1016/S1470-2045(13)70093-7pmid:23598172 |
[21] | Motzer RJ, Penkov K, Haanen J, et al. Avelumab plus axitinib versus sunitinib for advanced renal-cell carcinoma[J]. N Engl J Med, 2019, 380(12): 1103-1115. DOI: 10.1056/NEJMoa1816047. doi:10.1056/NEJMoa1816047 |
[22] | Powles T, Plimack ER, Soulières D, et al. Pembrolizumab plus axitinib versus sunitinib monotherapy as first-line treatment of advanced renal cell carcinoma (KEYNOTE-426): extended follow-up from a randomised, open-label, phase 3 trial[J]. Lancet Oncol, 2020, 21(12): 1563-1573. DOI: 10.1016/S1470-2045(20)30436-8. doi:10.1016/S1470-2045(20)30436-8pmid:33284113 |
[23] | 中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)肾癌诊疗指南 2022[M]. 北京: 人民卫生出版社, 2022: 50. |
[1] | 王盈, 刘楠, 郭兵.抗体药物偶联物在转移性乳腺癌治疗中的研究进展[J]. 国际肿瘤学杂志, 2024, 51(6): 364-369. |
[2] | 高凡, 王萍, 杜超, 褚衍六.肠道菌群与结直肠癌非手术治疗的相关研究进展[J]. 国际肿瘤学杂志, 2024, 51(6): 376-381. |
[3] | 范志鹏, 余静, 胡静, 廖正凯, 徐禹, 欧阳雯, 谢丛华.炎症标志物的变化趋势对一线接受免疫联合化疗的晚期非小细胞肺癌患者预后的预测价值[J]. 国际肿瘤学杂志, 2024, 51(5): 257-266. |
[4] | 王培鑫, 赵军, 徐世红, 姜朝阳, 王小强, 杨红娟.铁死亡相关机制在骨肉瘤中的应用进展[J]. 国际肿瘤学杂志, 2024, 51(5): 308-311. |
[5] | 张文馨, 夏泠, 彭晋, 周福祥.甲胎蛋白升高型胃肝样腺癌1例并文献复习[J]. 国际肿瘤学杂志, 2024, 51(5): 312-315. |
[6] | 杨毫, 施贵冬, 张程城, 张跃, 张力文, 付茂勇.信迪利单抗与替雷利珠单抗在进展期食管鳞状细胞癌新辅助治疗中的疗效及安全性对比[J]. 国际肿瘤学杂志, 2024, 51(4): 210-216. |
[7] | 萨蔷, 徐航程, 王佳玉.乳腺癌免疫治疗研究进展[J]. 国际肿瘤学杂志, 2024, 51(4): 227-234. |
[8] | 杨智, 陆以乔, 顾花艳, 丁佳玲, 郭贵龙.肿瘤微环境介导乳腺癌靶向治疗耐药的研究进展[J]. 国际肿瘤学杂志, 2024, 51(4): 235-238. |
[9] | 张栋岩, 王品, 魏秋亚, 邓成伍, 魏相相, 高远飞, 王琛.索凡替尼靶向联合卡培他滨和奥沙利铂治疗肝内胆管癌术后患者1例及文献复习[J]. 国际肿瘤学杂志, 2024, 51(4): 249-253. |
[10] | 孙维蔚, 姚学敏, 王鹏健, 王静, 贾敬好.基于血液学指标探讨免疫治疗晚期非小细胞肺癌预后因素及列线图构建[J]. 国际肿瘤学杂志, 2024, 51(3): 143-150. |
[11] | 刘玉兰, 井海燕, 孙静, 宋伟, 沙丹.胃癌免疫治疗疗效预测及预后标志物的研究进展[J]. 国际肿瘤学杂志, 2024, 51(3): 175-180. |
[12] | 马正红, 姜超.非小细胞肺癌KRASG12C突变的研究进展[J]. 国际肿瘤学杂志, 2024, 51(2): 95-98. |
[13] | 崔腾璐, 吕璐, 孙鹏飞.放疗联合免疫治疗在头颈部鳞状细胞癌治疗中的应用[J]. 国际肿瘤学杂志, 2023, 50(9): 548-552. |
[14] | 黄辉, 丁江华.靶向FGFR2治疗晚期胆管癌的研究进展[J]. 国际肿瘤学杂志, 2023, 50(9): 569-573. |
[15] | 李开春, 丁昌利, 于文艳.安罗替尼联合特瑞普利单抗治疗晚期肺肉瘤样癌1例[J]. 国际肿瘤学杂志, 2023, 50(8): 511-512. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||