中文摘要
近期研究探索了在多种局部晚期肿瘤中使用新辅助双免疫检查点抑制剂(ICIs)联合降阶梯化疗的潜力,以确定这种联合方案能否在增强肿瘤应答的同时尽量减少毒性。
然而,针对局部晚期宫颈癌(LACC)的相关研究较少。在本研究中,我们呈现了NICE-CC试验中的一例病例,评估新辅助双免疫检查点抑制剂(ICI)联合降阶梯化疗方案治疗LACC的可行性。一例IIB期LACC患者具有高肿瘤负荷,并推测为“免疫冷”状态,表现为PD-L1阴性,联合阳性评分(CPS)为0。该患者在接受一个周期的新辅助iparomlimab和tuvonralimab(同时靶向PD-1和CTLA-4)联合标准化疗,随后再接受两个周期的iparomlimab和tuvonralimab后,达到了病理完全缓解(pCR)。在机制上,该病例的肿瘤微环境(TME)以大量TIL(肿瘤浸润淋巴细胞)(TILs)和三级淋巴结构(TLSs)为特征,这可能与对ICI治疗应答改善相关。
总之,该病例凸显了一个周期的新辅助双免疫治疗联合标准化疗,随后再接受两个周期的双免疫治疗,用于治疗LACC的潜力。这一创新性治疗方案值得在正在进行的NICE-CC试验中进一步研究。
展开英文摘要原文
Recent research has explored the potential of using neoadjuvant dual immune checkpoint inhibitors (ICIs) combined with de-escalated chemotherapy in several locally advanced tumors to determine if such a combined regimen can enhance tumor response while minimizing toxicity.
However, few related studies are focused on locally advanced cervical cancer (LACC). In this study, we present a case from the NICE-CC trial evaluating the feasibility of neoadjuvant dual immune checkpoint inhibitor (ICI) combined with a de-escalated chemotherapy regimen for LACC. A patient with stage IIB LACC had a high tumor burden and a presumed "immune cold" status, indicated by PD-L1 negativity with a Combined Positive Score (CPS) of 0.
The patient achieved a pathological complete response (pCR) after receiving one cycle of neoadjuvant iparomlimab and tuvonralimab (simultaneously targeting PD-1 and CTLA-4) combined with standard chemotherapy, followed by two additional cycles of iparomlimab and tuvonralimab. Mechanically, the tumor microenvironment (TME) in this case was characterized by an abundance of tumor-infiltrating lymphocytes (TILs) and tertiary lymphoid structures (TLSs), which might be associated with improved responses to ICI therapy.
In conclusion, this case highlights the potential of one cycle of neoadjuvant dual immunotherapy combined with standard chemotherapy, followed by two additional cycles of dual immunotherapy, for the treatment of LACC. This innovative treatment regimen warrants further investigation in the ongoing NICE-CC trial.
论文信息
- 作者
- Lin J、He H、Liu B、He T、Lei X、Guo X、Chen X、Zheng X
- 单位
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.China
- 文献类型
- 病例报告
- 期刊
- Frontiers in immunology2026