免疫检查点抑制剂联合抗血管生成药物治疗肺肉瘤样癌：1例病例报告及文献综述

The Combination of Immune Checkpoint Blockade and Antiangiogenic Agents for Treating Pulmonary Sarcomatoid Carcinoma: A Case Report and Literature Review

摘要: 肺肉瘤样癌(Pulmonary sarcomatoid carcinoma, PSC)是一种罕见的非小细胞肺癌(non-small cell lung cancer, NSCLC)，具有分化差、进展迅速、易远处转移等特点，对常规抗肿瘤治疗的应答率低，预后差。最近的研究发现，PSC通常具有潜在的可靶向的基因组改变、高肿瘤突变负荷、高水平的免疫细胞浸润和更高的PD-L1表达，这为我们提供了PSC患者可能受益于免疫治疗的前景。由于肿瘤的生长和转移依赖于血管生成，抗血管生成治疗在癌症治疗中发挥着越来越重要的作用。目前，已有研究证实抗血管生成药物联合免疫检查点抑制剂(Immune checkpoint inhibitors, ICIs)治疗晚期NSCLC的有效性和安全性，但未发现PSC的获益。在这里，我们报道的一例晚期PSC患者使用ICI联合抗血管生成治疗的成功病例显示了显著的疗效，这为PSC患者提供了一个有前途的选择。

Abstract: Pulmonary sarcomatoid carcinoma (PSC), characterized by poor differentiation, aggressive progres-sion, and easy distant metastasis, is a rare type of non-small cell lung cancer (NSCLC), which shows a low response rate to conventional antitumor therapies and has a poor prognosis. Recent studies have found that PSC commonly harbors potential targetable genomic alterations, high tumor muta-tion burden, high level of immune-cell infiltration, and higher PD-L1 expression, which gives us the prospect that PSC patients may be able to benefit from immunotherapy. As tumor growth and me-tastasis depend on angiogenesis, antiangiogenesis therapy is playing an increasingly crucial role in cancer treatment. At present, some studies have confirmed the efficacy and safety of antiangiogenic drugs combined with Immune checkpoint inhibitors (ICIs) in the treatment of advanced NSCLC, but no benefit has been found in PSC. Here, the successful case of a patient with advanced PSC using ICI combined with antiangiogenic therapy we reported shows significant benefits, which provides a promising option for PSC patients.