Abstract:
PD-1 blockade is now routine for nearly all patients with non-small lung cancer. Acquired resistance to PD-1 blockade - defined generally as an initial response followed later by progression [1-3] is a common yet poorly understood concept. A key clinical challenge to insight has been a lack of standard guidance for clinical management of a case of suspected acquired resistance. The infrequency of performing tumor biopsies and the uncertainty of actionability from tissue sampling likely also contribute to limited insight into the biology of acquired resistance [4]. To address this knowledge gap and to highlight the value of tumor and liquid biopsy, we present a representative case of suspected acquired resistance to PD-1 blockade and propose a multi-modal guide for approaching this clinical scenario.
摘要:
PD-1阻断现在是几乎所有非小细胞肺癌患者的常规治疗方法。对PD-1阻断的获得性抗性-通常定义为最初的反应,然后是进展[1-3]是一个常见但知之甚少的概念。对洞察力的关键临床挑战是缺乏对疑似获得性耐药病例的临床管理的标准指导。进行肿瘤活检的频率和组织采样的可操作性的不确定性也可能导致对获得性耐药性生物学的认识有限[4]。为了解决这一知识差距,并强调肿瘤和液体活检的价值,我们介绍了一例疑似获得性PD-1阻断剂耐药的代表性病例,并提出了一个多模式指南来处理这一临床情景.