Report of two cases of pseudoprogression in patients with non-small cell lung cancer treated with nivolumab-including histological analysis of one case after tumor regression
Report of two cases of pseudoprogression in patients with non-small cell lung cancer treated with nivolumab-including histological analysis of one case after tumor regression
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DOI：
10.1016/j.lungcan.2016.10.014
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发表时间：
2016-12-01
期刊：
影响因子：
5.3
通讯作者：
Nakagawa, Kazuhiko
中科院分区：
文献类型：
--
作者：
Tanizaki, Junko;Hayashi, Hidetoshi;Nakagawa, Kazuhiko
最近nivolumab和其他免疫检查点抑制剂被批准用于治疗某些实体肿瘤，包括非小细胞肺癌（NSCLC），这改变了癌症治疗。然而，确定这些药物在经典细胞毒药物或其他靶向治疗中未见的效果将是很重要的。我们在此报告两例NSCLC在纳武单抗治疗期间显示所谓的假进展。在这两个病例中，影像学评估显示肝转移病变最初进展，但随后在持续使用纳武单抗期间缩小，治疗也导致血清癌胚抗原水平下降。1例肝转移灶消退后的组织学评估显示，纤维化组织含有浸润的CD3、CD4或CD8阳性淋巴细胞，但没有活的肿瘤细胞，提示即使在病理完全反应后也存在持久的免疫反应。鉴于免疫检查点抑制剂在非小细胞肺癌或其他实体肿瘤患者中的使用越来越多，进一步的临床评估和病理评估有必要更好地了解这种假性进展。2016爱思唯尔爱尔兰有限公司版权所有。
The recent approval of nivolumab and other immune-checkpoint inhibitors for the treatment of certain solid tumors including non small cell lung cancer (NSCLC) has transformed cancer therapy. However, it will be important to characterize effects of such agents not seen with classical cytotoxic drugs or other targeted therapeutics. We here report two cases of NSCLC showing so-called pseudoprogression during nivolumab treatment. In both cases, imaging assessment revealed that liver metastatic lesions initially progressed but subsequently shrank during continuous nivolumab administration, with treatment also resulting in a decline in serum levels of carcinoembryonic antigen. Histological evaluation of the liver metastatic lesion of one case after regression revealed fibrotic tissue containing infiltrated lymphocytes positive for CD3, CD4, or CD8 but no viable tumor cells, suggestive of a durable immune reaction even after a pathological complete response. Given the increasing use of immune-checkpoint inhibitors in patients with NSCLC or other solid tumors, further clinical evaluation and pathological assessment are warranted to provide a better understanding of such pseudoprogression. (C) 2016 Elsevier Ireland Ltd. All rights reserved.