非小细胞肺癌(NSCLC)占全球肺癌病例的大多数。脑转移(BM)经常使NSCLC复杂化,并预示着预后不良。为了控制神经症状,手术切除后通常是脑放疗(RT)。然而,RT通常因神经毒性而复杂化。对于携带阳性驱动基因的肿瘤患者,酪氨酸激酶抑制剂被认为是护理标准。然而,对于无驱动基因突变者的治疗方案仍存在争议.程序性死亡受体1(PD-1)/配体1(PD-L1)抑制已成为PD-L1阳性肿瘤NSCLC患者的新治疗策略。以及那些无症状BM的人。然而,抗PD-1抗体对此类特定群体中活性BM的影响尚未确定.在此,我们介绍了一例65岁的NSCLC和高表达PD-L1的BM患者。该患者接受了BM的手术切除,然后进行了31个周期的zimbererelimab的一线单一疗法,一种新的抗PD-1抗体,并且已经实现了24个月的无进展生存期和无颅内复发生存期.据我们所知,这是关于zimberelimab对原发性肺癌BM的颅内影响的首次报道。此病例报告可能有助于了解不同抗PD-1抗体对此类人群的颅内效应。
Non-small cell lung cancer (
NSCLC) accounted for the majority of lung cancer cases worldwide. Brain metastases (BM) frequently complicate
NSCLC and portend a dismal prognosis. To control neurological symptoms, surgical resection is commonly followed by brain radiotherapy (RT). However, RT is often complicated by neurotoxicity. For patients with tumors that harbor positive driver genes, tyrosine kinase inhibitors are considered the standard of care. Nevertheless, treatment options for those without driver gene mutations are still debated. Programmed death receptor 1 (PD-1)/ligand 1 (PD-L1) inhibition has emerged as a novel therapeutic strategy for
NSCLC patients with PD-L1-positive tumors, as well as for those with asymptomatic BM. However, the effect of anti-PD-1 antibodies on active BM within such specific populations is undetermined. Herein we present a
case of a 65-year-old patient with
NSCLC and high PD-L1-expressing BM. The patient underwent surgical resection of BM followed by first-line monotherapy with 31 cycles of zimberelimab, a novel anti-PD-1 antibody, and has already achieved 24 months of progression-free survival and intracranial recurrence-free survival. To our knowledge, this is the first report regarding the intracranial effect of zimberelimab on BM from primary lung cancer. This
case report might facilitate an understanding of the intracranial effects of different anti-PD-1 antibodies for such populations.