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树突状细胞疫苗联合厄洛替尼治疗一例无法手术的肺腺癌患者:病例报告

英文原题:Dendritic cell vaccination in combination with erlotinib in a patient with inoperable lung adenocarcinoma: a case report.

PubMed 2024/02/10(内容时间) J Med Case Rep Q3 · IF 0.8(JCR 2025)

研究概要

标准抗癌治疗联合负载Wilms瘤1和黏蛋白1疫苗的树突状细胞可能对这类不可切除肺腺癌患者具有治疗作用。

研究思路结论见上方概要

不可切除晚期肺癌患者的满意治疗尚未确立。我们报告一例不可切除晚期肺癌(IIIb期:T2aN3M0)患者,接受总计15剂负载Wilms瘤1和黏蛋白1疫苗的树突状细胞联合厄洛替尼(一种小分子表皮生长因子受体酪氨酸激酶抑制剂)治疗超过699天,无复发或转移。 病例介绍:一名63岁韩国女性通过病理学和计算机断层扫描诊断为肺腺癌。腺癌显示表皮生长因子受体(EGFR)突变,无间变性淋巴瘤激酶表达,程序性死亡配体1表达低于1%。她单独接受厄洛替尼治疗约1个月。随后她接受厄洛替尼和负载Wilms瘤1和黏蛋白1疫苗的树突状细胞治疗。首次接种后48小时,接种部位红斑直径为30 mm。此外,在接种期间其维持在20 mm以上。这些结果提示疫苗诱导了抗肿瘤免疫。值得注意的是,基于正电子发射断层扫描/计算机断层扫描和计算机断层扫描的氟脱氧葡萄糖摄取,接受八剂负载Wilms瘤1和黏蛋白1疫苗的树突状细胞联合厄洛替尼治疗237天后,肿瘤大小显著缩小至12 mm,缩小65.7%。有趣的是,联合治疗321天后,临床发现改善,基于计算机断层扫描未检测到肿瘤。肿瘤消失的验证在治疗开始后持续至少587天,无任何复发或转移迹象。

展开英文摘要原文

BACKGROUND: Satisfactory treatment for patients with unresectable advanced lung cancer has not yet been established. We report a case of unresectable advanced lung cancer (stage IIIb: T2aN3M0) treated with a total of 15 doses of dendritic cells pulsed with a Wilms' tumor 1 and mucin 1 vaccine in combination with erlotinib, a small molecule epidermal growth factor receptor tyrosine kinase inhibitor, for more than 699 days without recurrence or metastasis. CASE PRESENTATION: A 63-year-old Korean woman was diagnosed with lung adenocarcinoma by pathology and computed tomography. The adenocarcinoma showed an epidermal growth factor receptor (EGFR) mutation, no anaplastic lymphoma kinase expression, and less than 1% expression of programmed death ligand 1. She received erlotinib alone for approximately 1 month. She then received erlotinib and the dendritic cells pulsed with Wilms' tumor 1 and mucin 1 vaccine. The diameter of the erythema at the vaccinated sites was 30 mm at 48 hours after the first vaccination. Moreover, it was maintained at more than 20 mm during the periods of vaccination. These results suggested the induction of antitumor immunity by the vaccine. Remarkably, the tumor size decreased significantly to 12 mm, a 65.7% reduction, after combined therapy with eight doses of the dendritic cells pulsed with Wilms' tumor 1 and mucin 1 vaccine and erlotinib for 237 days based on fluorodeoxyglucose uptake by positron emission tomography/computed tomography and computed tomography. Interestingly, after 321 days of combination therapy, the clinical findings improved, and no tumor was detected based on computed tomography. Validation of the tumor's disappearance persisted for at least 587 days after treatment initiation, without any indication of recurrence or metastasis. CONCLUSION: Standard anticancer therapy combined with the dendritic cells pulsed with Wilms' tumor 1 and mucin 1 vaccine may have therapeutic effects for such patients with unresectable lung adenocarcinoma.

论文信息

作者
Kosumi T、Kobayashi M、Shimodaira S、Sugiyama H、Koido S
单位
Kyushukouseikai Clinic, 1-2-12 Tenjin, Chuo-Ku, Fukuoka-Shi, 810-0001, Japan. kosumi@poppy.ocn.ne.jp.Japan
文献类型
病例报告
期刊
Journal of medical case reports2024 Feb 10
原文标识
PubMed 38336778 · DOI 10.1186/s13256-024-04363-z