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PD-L1低表达胸腺鳞癌多疗程治疗分析一例
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Abstract:
背景：胸腺鳞状细胞癌(Thymic Squamous Cell Carcinoma, TSCC)罕见且侵袭性强，晚期患者后线治疗缺乏标准方案。本文报道了一例53岁女性TSCC患者，在历经多线治疗失败后，接受免疫联合抗血管生成治疗，获得长久生存，且未见严重不良反应。诊疗经过：患者初诊为转移性TSCC，历经紫杉醇类 + 铂类(Taxol + Cisplatin, TP)及环磷酰胺 + 阿霉素类 + 铂类(Cyclophosphamide + Adriamycin + Cisplatin, CAP)方案治疗失败后，接受免疫联合抗血管生成治疗。首程卡瑞利珠单抗联合安罗替尼治疗的无进展生存期(Progression-Free Survival, PFS)长达34月，进展后行阿得贝利单抗 + 安罗替尼再挑战治疗获长期生存，不良反应耐受可。启示：PD-L1低表达TSCC患者可从免疫–抗血管联合方案中获益，为转移性TSCC后线治疗提供了新的思路。
Background: Thymic squamous cell carcinoma (TSCC) is rare and highly aggressive, lacking standard regimens for advanced patients in later lines of therapy. This report describes a 53-year-old female TSCC patient who achieved prolonged survival with immunotherapy combined with anti-angiogenic therapy after failing multiple lines of treatment, without severe adverse reactions. Diagnosis and Treatment: Initially diagnosed with metastatic TSCC, the patient failed taxane plus platinum (Taxol + Cisplatin, TP) and cyclophosphamide plus anthracycline plus platinum (Cyclophosphamide + Adriamycin + Cisplatin, CAP) regimens. She subsequently received immunotherapy combined with anti-angiogenic therapy. The first course of camrelizumab plus anlotinib achieved a progression-free survival (PFS) of 34 months. Upon progression, adebrelimab plus anlotinib rechallenge therapy resulted in prolonged survival, with tolerable adverse reactions. Implications: Patients with low PD-L1 expression TSCC may benefit from combined immunotherapy-anti-angiogenic regimens, providing a novel approach for later-line therapy in metastatic TSCC.
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