肺腺癌患者在Atezolizumab治疗过程中出现假性进展的案例报道

A Case of Pseudoprogression During Atezolizumab Therapy in Lung Adenocarcinoma

肺癌是全球癌症相关死亡的最常见原因。根据病理类型的不同,肺癌可分为非小细胞肺癌(non-small cell lung cancer, NSCLC)和小细胞肺癌(small cell lung cancer, SCLC)。其中NSCLC约占所有肺癌患者的85%。免疫检查点抑制剂(immune checkpoint inhibitors, ICIPs)是一类针对程序性死亡受体-1(programmed cell death protein 1, PD-1)及其配体(programmed death-ligand 1, PD-L1)的抑制剂,已有研究结果显示ICIPs在许多不同的癌症中具有良好且持久的抗癌疗效,其中抗PD-L1单克隆抗体Atezolizumab(MPDL3280)正在实体瘤和恶性血液病中开展临床研究。据报道,假性进展是免疫治疗中可能出现的独特现象之一。本文中我们报道了1例晚期NSCLC接受免疫治疗后发生假性进展的病例,希望这一案例可以更好地帮助临床医生恰当评估免疫治疗的疗效,并作出最恰当的治疗决策。

Lung cancer is the most common cause of cancer-related death worldwide.There are two classes of lung cancer:non-small cell lung cancer(NSCLC)and small cell lung cancer(SCLC).NSCLC represents approximately 85%of all lung cancer cases.Immune checkpoint inhibitors(ICIPs)are a class of inhibitors of programmed death-1 and programmed death-ligand 1.Preclinical studies have shown that ICIPs have shown good clinical efficacy and durable response in diverse cancers.Among them,atezolizumab(MPDL3280),an anti-PD-L1 monoclonal antibody,is being investigated as a potential therapy against solid tumors and hematologic malignancies in humans.Pseudoprogression is reported as one of the unique phenomena with immune therapeutic agents.Here we report case of a person with advanced NSCLC who developed pseudoprogression after receiving immunotherapy.We hope this case could help clinicians to make appropriate decision when assessing therapeutic effects of immunotherapy.