Alpha-fetoprotein (AFP) as tumor marker in a patient with urothelial cancer with exceptional response to anti-PD-1 therapy and an escape lesion mimic.
Alpha-fetoprotein (AFP) as tumor marker in a patient with urothelial cancer with exceptional response to anti-PD-1 therapy and an escape lesion mimic.
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DOI：
10.1186/s40425-018-0394-y
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发表时间：
2018-09-12
影响因子：
10.9
通讯作者：
Izar B
中科院分区：
文献类型：
--
作者：
Melms JC;Thummalapalli R;Shaw K;Ye H;Tsai L;Bhatt RS;Izar B
在抗PD - 1治疗完全缓解的患者中出现新病灶，高度令人担忧是耐药性逃逸病灶。在此，我们介绍一例62岁对化疗耐药的转移性尿路上皮癌患者，其对帕博利珠单抗完全缓解。患者的疾病负荷与肿瘤表达的甲胎蛋白（AFP）血清水平密切相关，并作为一种准确的肿瘤标志物。监测影像显示一个孤立的肺部结节在增大，类似逃逸病灶，但AFP水平没有升高。对该病灶的活检显示为实质内良性淋巴结，没有转移性癌的证据。该病例表明，在一些患者中，其肿瘤异常表达的生物标志物，如该患者的AFP，可作为抗PD - 1治疗反应的肿瘤标志物，并强调了通过病理检查确认潜在逃逸病灶的重要性。
The development of a new lesion in a patient with a complete remission to anti-PD-1 therapy is highly concerning for a drug resistant escape lesion. Here, we present a case of a 62-year-old patient with chemotherapy-resistant metastatic urothelial cancer who had a complete remission to pembrolizumab. The patient’s disease burden tracked closely to serum levels of alpha-fetoprotein (AFP) expressed by the tumor and served as an accurate tumor marker. Surveillance imaging revealed a solitary growing pulmonary nodule mimicking an escape lesion in the absence of an increase in AFP levels. Biopsy of this lesion revealed a benign intraparenchymal lymph node with no evidence of metastatic carcinoma. This case indicates that in some patients, biomarkers aberrantly expressed by their tumors, such as AFP in this patient, may be used as a tumor marker for response to anti-PD-1 therapy and emphasizes the importance of confirming potential escape lesions by pathologic examination.
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DOI：
10.1002/hep.29844
发表时间：
2018-08
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Zhu W;Peng Y;Wang L;Hong Y;Jiang X;Li Q;Liu H;Huang L;Wu J;Celis E;Merchen T;Kruse E;He Y
通讯作者：
He Y
影响因子：
11.5
作者：
Liu, Hong;Xu, Yiyang;Liu, Cheng
通讯作者：
Liu, Cheng
影响因子：
64.5
作者：
Sharma P;Hu-Lieskovan S;Wargo JA;Ribas A
通讯作者：
Ribas A
影响因子：
45.3
作者：
Hodi, F. Stephen;Hwu, Wen-Jen;Wolchok, Jedd D.
通讯作者：
Wolchok, Jedd D.