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肿瘤消退发生于自体肿瘤裂解物负载树突状细胞疫苗免疫治疗后:示例病例

英文原题:Tumor regression following autologous tumor lysate-loaded dendritic cell vaccination immunotherapy: illustrative case.

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Tumor regression following autologous tumor lysate-loaded dendritic cell vaccination immunotherapy: illustrative case.

PubMed 2024/07/08(内容时间) J Neurosurg Case Lessons Q4 · IF 0.7(JCR 2025)

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研究思路按摘要原文分段

尽管经过多年研究,4级胶质瘤的标准治疗(SOC)在过去20年中几乎未发生变化。自体肿瘤裂解物负载树突状细胞疫苗(DCVax-L)是一种新型免疫疗法,在3期试验中已显示出显著的生存获益。 观察:一名34岁男性因发作性头晕就诊,随后被诊断为一个较大的额-岛-颞叶肿瘤,可能为高级别。他接受了清醒开颅减瘤手术,额叶和杏仁核可见残留肿瘤。肿瘤组织病理学报告为异柠檬酸脱氢酶(IDH)突变型甲基化4级星形细胞瘤。他接受了SOC治疗,同时接受了一个疗程的DCVax-L。监测影像显示囊性变,随后额叶残留肿瘤缩小;杏仁核的残留病灶已完全消退。患者临床状况保持良好,并已恢复至术前功能状态。 经验:作者报告了一例4级星形细胞瘤患者,在SOC辅助治疗之外还接受了DCVax-L治疗。肿瘤消退的模式和程度非常罕见,不符合单独辅助SOC治疗所见或预期的表现。在SOC中加入DCVax-L为这种难治性疾病的管理开辟了新途径。https://thejns.org/doi/10.3171/CASE24112。

展开英文摘要原文

BACKGROUND: Despite years of research, the standard of care (SOC) treatment for grade 4 glioma has remained virtually unchanged for the last 2 decades. Autologous tumor lysate-loaded dendritic cell vaccination (DCVax-L), a novel immunotherapy, has demonstrated a significant survival benefit in a phase 3 trial. OBSERVATIONS: A 34-year-old male presented with episodes of lightheadedness and was subsequently diagnosed with a large fronto-insulo-temporal tumor, likely to be high grade. He underwent an asleep craniotomy for debulking, with a residual tumor noted in the frontal lobe and amygdala. Tumor histopathology was reported as isocitrate dehydrogenase (IDH) mutant methylated grade 4 astrocytoma. He received SOC treatment, alongside a course of DCVax-L. Surveillance imaging showed cystic transformation followed by a reduction in size of the residual tumor in the frontal lobe; the residual in the amygdala had regressed entirely. The patient remained clinically well and had returned to his preoperative functionality. LESSONS: The authors report a patient with grade 4 astrocytoma who received DCVax-L treatment in addition to SOC adjuvant therapy. The pattern and extent of tumor regression are highly unusual and atypical for what is seen or expected with adjuvant SOC treatment alone. The addition of DCVax-L to SOC opens new avenues in the management of this difficult disease. https://thejns.org/doi/10.3171/CASE24112.

论文信息

作者
Kamaludin AI、Sibtain N、Ashkan K
单位
Departments of Neurosurgery, King's College Hospital, London, United Kingdom.United Kingdom
期刊
Journal of neurosurgery. Case lessons2024 Jul 1
原文标识
PubMed 38976918 · DOI 10.3171/CASE24112