阿特唑单抗辅助治疗期间原发性肺腺癌转化为小细胞癌并发复发性脑转移1例。

IF 2.3 3区医学 Q3 ONCOLOGY Thoracic Cancer Pub Date : 2025-01-01 Epub Date: 2024-12-27 DOI:10.1111/1759-7714.15512

Nao Kobayashi, Noriaki Sunaga, Masakiyo Yatomi, Ikuo Wakamatsu, Sohei Muto, Hayato Ikota, Rei Yamaguchi, Yoichi Ohtaki, Toshiteru Nagashima, Nobuteru Kubo, Tomomi Masuda, Yosuke Miura, Hiroaki Tsurumaki, Reiko Sakurai, Yasuhiko Koga, Takeshi Hisada, Toshitaka Maeno

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引用次数: 0

摘要

从非小细胞到小细胞肺癌（SCLC）的组织学转化是免疫检查点抑制剂的抵抗机制。我们在此报告一例肺腺癌在阿特唑单抗辅助治疗期间发生肝和脑转移。患者接受开颅手术切除脑转移灶，病理诊断为SCLC。随后，他接受了以铂为基础的杜伐单抗化疗，导致肝转移持续消退。该病例通过从腺癌到小细胞肺癌的组织学转化证明了转移性脑肿瘤获得性对阿特唑单抗的耐药性。因此，如果非小细胞肺癌患者在免疫检查点抑制剂治疗期间出现复发性疾病，则需要重新活检。

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A Case of Primary Lung Adenocarcinoma With Recurrent Brain Metastasis due to Transformation to Small Cell Carcinoma During Adjuvant Atezolizumab Therapy.

Histologic transformation from non-small cell to small cell lung cancer (SCLC) is a resistance mechanism to immune checkpoint inhibitors. We report herein a case of lung adenocarcinoma who developed liver and brain metastases during adjuvant atezolizumab therapy. The patient underwent a craniotomy to resect a brain metastasis, which was pathologically diagnosed as SCLC. He subsequently received platinum-based chemotherapy with durvalumab, resulting in sustained regression of the liver metastases. This case demonstrates a metastatic brain tumor-acquired resistance to atezolizumab through histologic transformation from adenocarcinoma to SCLC. Therefore, rebiopsy is needed if recurrent disease appears during immune checkpoint inhibitor treatment in patients with non-small cell lung cancer.

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.