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首页> 外文期刊>Pancreas >Combined Antiangiogenic Therapy and Immunotherapy Is Effective for Pancreatic Cancer With Mismatch Repair Proficiency but High Tumor Mutation Burden A Case Report
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Combined Antiangiogenic Therapy and Immunotherapy Is Effective for Pancreatic Cancer With Mismatch Repair Proficiency but High Tumor Mutation Burden A Case Report

机译：联合抗血管生成治疗和免疫疗法对胰腺癌的不匹配修复熟练程度有效，但高肿瘤突变负担案例报告

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摘要

Immunotherapy has been recommended as a second-line treatment only for high microsatellite instability or DNA mismatch repair deficiency advanced pancreatic cancer in National Comprehensive Cancer Network guidelines. Here, we report a case with a good response to immunotherapy in pancreatic cancer with mismatch repair proficiency. A 55-year-old woman diagnosed with pancreatic cancer cT4N1M1 (liver, lung) who harbored ERBB2 mutations with high tumor mutation burden (TMB) underwent multiple therapies and survived 19 months. A partial response in pancreatic cancer was observed when the patient was treated with combined antiangiogenic therapy and immunotherapy after a series of ineffective treatments. Neutrophil-to-lymphocyte ratio (NLR), a predictive marker of efficacy of immunotherapy, confirmed that immunotherapy resulted in the partial response in pancreatic cancer. To our knowledge, this is the first to report advanced pancreatic cancer with mismatch repair proficiency had a good response to immunotherapy, and this is the first to report an association between high blood-based TMB or NLR and improved clinical outcomes in pancreatic cancer. Therefore, TMB may also be a biomarker for immunotherapy of pancreatic cancer, and NLR may be a prospective predictive marker for efficacy of immunotherapy in pancreatic cancer.
机译：在国家综合癌症网络准则中，推荐了免疫疗法仅用于高微卫星不稳定性或DNA错配修复缺陷先进的胰腺癌。在这里，我们报告了伴随着胰腺癌免疫疗法的良好反应，具有不匹配的修复熟练程度。一名55岁的女性被诊断出患有胰腺癌CT4N1M1（肝脏，肺），他患有高肿瘤突变负荷（TMB）的ERBB2突变进行了多种疗法，并存活了19个月。在一系列无效治疗后用组合抗血管生成治疗和免疫疗法治疗患者时，观察到胰腺癌中的部分反应。中性粒细胞到淋巴细胞比（NLR），免疫疗法疗效的预测标志，证实免疫疗法导致胰腺癌中的部分反应。据我们所知，这是第一个报告先进的胰腺癌，不匹配修复熟练能力对免疫疗法有良好的反应，这是第一个报告高血液基TMB或NLR之间的关联，并改善胰腺癌中的临床结果。因此，TMB也可以是用于胰腺癌免疫疗法的生物标志物，NLR可能是免疫疗法在胰腺癌中的疗效的前瞻性预测标志。

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