Advanced lung cancer PFS is 3 years, the treatment plan is ...

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In the past 20 years, targeted therapy has brought tremendous changes to the diagnosis and treatment of lung cancer. The survival of advanced lung cancer has been extended from several months to 39 months. For patients with advanced lung cancer who drive gene negative, immunotherapy can bring survival benefits. Professor Yu Hui of the Cancer Hospital of Fudan University shared cases of driving gene -negative advanced lung cancer. After treatment, there was no progressive survival period for 3 years. Cancer channels for the medical community are specially sorted out for the treatment process to readers.

Basic information

Patient, female, 54 years old.

Time: November 2018

Prosecution: waist soreness, unwell, increase January in January

Current medical history: 2018.12 The PET-CT of the outer hospital shows that the tip of the left lung tip is occupied by the tip of the left lung, and the FDG metabolism increases. Considering the peripheral lung cancer with the left lung leaf, the hypertrophy metastasis, and multiple bone transfer. 2018.12.21 chest CT: upper left lung leaves occupy positions, hypotensive lymph node metastasis, and multiple ribs of bilateral ribs. A little inflammation under the right lung.

Previous history: The history of the past is healthy, and the history of epidemic water without epidemic zone is exposed to history.

Personal history: no history of smoking and drinking, family history of no genetic tumor.

▌ Physical examination:

ECOG1 points, NRS3 points, Shenqing, superficial lymph nodes and swelling, double lung breathing sounds, not smelling and dry wetness, heart rate 80 times/min, law Qi, not hearing and pathological murmur, flat abdomen flat, abdomen flat, abdomen flat, abdomen flat Soft, the liver and spleen ribs were not reach, but not stubborn and obvious blocks.

▌ Auxiliary inspection:

1. (left lung puncture) non -small cell carcinoma, which is in line with low differentiation lung adenocarcinoma. Immune group TTF-1 (+), P40 (-), Alk-Ventana (-), PD-L1 22C3 TPS about 90%.

2. Gene test: EGFR, KRAS, ALK, ROS1, MET are negative.

3. No abnormalities in the brain MR and abdomen CT.

： Clinical diagnosis:

Left lung adenocarcinoma bone metastasis gene detect negative PD-L1 22C3 TPS 90%.

Treat

Patients voluntarily participate in Checkmate227 clinical trials. On January 23, 2019, the patient accepted the Ipmu Monopoly 49mg Q6W+Nawuli Mippitive 147mg Q2W. Treatment was over on November 24, 2020.

After treatment, the patient's curative effect was evaluated as PR.

Great treatment process imaging changes

During the treatment, patients with I ° oral ulcers, increased lipase II, and increased thyroid function I. The evaluation may be related to the drug side reaction, and it has nothing to do with the immune response.

The follow -up CT can be seen that in November 2019, the original tumor stove changed from empty holes to solid, does this mean that the disease progresses after the use of dual -free solutions?

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case discussion

In recent years, immunotherapy has greatly changed the pattern of lung cancer. However, immunotherapy is facing the problem of some patients' unsatisfactory response and high proportion of primary/adaptability. Therefore, exploring the more efficacy of immune combination plans has become a hot spot in the field of lung cancer.

Nawuli Mipida and Ipmu Mipida are known as "immune twins" and have excellent performance in each cancer species. CheckMate 227 Studies show that regardless of PD-L1 expression, Ipmu Mipida+Nawuliyu Mippitteia can bring better objective relief rates (ORR) and alleviate duration (DOR).

Among patients with lung cancer at different PD-L1 expression levels, Nawuli Mippitive+Ipmu Mippochemical can get ORR and DOR

In terms of safety, the incidence of adverse events during the treatment of dual exemptions is lower, and no new immune -related adverse reactions occur.

The first release of this article: the medical world tumor channel

Author of this article:

Editor in charge: Sweet

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