帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
英文原题:Complete Cure of Inoperable Stage IV Locally Advanced Hypopharyngeal Squamous Cell Carcinoma by an Innovative Combination Cancer Immunotherapy Consisting of Radiation, Immune Checkpoint Inhibitors, and Dendritic Cell Vaccine.
我们报告一例68岁男性局部晚期(LA)头颈癌(HNC)(LA-HNC)病例。
我们报告一例68岁男性局部晚期(LA)头颈癌(HNC)(LA-HNC)病例。该患者被诊断为不可手术的IVA期下咽鳞状细胞癌,原发灶2 cm,并有三个淋巴结转移癌。该患者接受了一种创新的联合癌症免疫治疗(iCCI),包括放疗、免疫检查点抑制剂以及辅助/杀伤杂交表位长肽(H/K-HELP)脉冲树突状细胞疫苗。构成iCCI的这三种治疗已知可对肿瘤引流淋巴结(TDLNs)发挥免疫调节作用,并改善肿瘤微环境(TMEs)中的抗肿瘤免疫,从而减少肿瘤生长。令人惊讶的是,接受iCCI治疗的患者在未接受标准化疗的情况下,包括原发癌和淋巴结转移癌在内的所有癌症均获得完全治愈。该患者至今已近两年仍无癌生存。尽管癌症的破坏机制尚未确定,我们推测这种iCCI可能改善了患者肿瘤部位周围包括TDLNs和TME在内的抗肿瘤免疫能力。我们开发的iCCI未来将成为克服不可手术癌症的一种有前景的策略。
We report the case of a 68-year-old man with locally advanced (LA) head and neck cancer (HNC) (LA-HNC). The patient was diagnosed with inoperable stage IVA hypopharyngeal squamous cell carcinoma with 2 cm primary and three lymph node metastatic cancers. The patient was treated with an innovative combination cancer immunotherapy (iCCI) consisting of radiotherapy, immune checkpoint inhibitors, and helper/killer-hybrid epitope long peptides (H/K-HELP)-pulsed dendritic cell vaccine. These three treatments constituting iCCI are known to show an immunomodulating effect on tumor-draining lymph nodes (TDLNs) and improve antitumor immunity in tumor microenvironments (TMEs) to reduce tumor growth. Surprisingly, the patient treated with iCCI showed a complete cure for all the cancers including primary and lymph node-metastatic cancers without standard chemotherapy. The patient is still cancer-free for almost two years. Although the destruction mechanism of cancer is not determined, we speculate this iCCI might improve the patient's antitumor immune capability around tumor sites including TDLNs and TME. Our developed iCCI will become a promising strategy to overcome inoperable cancers in the future.
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