Babette J A Verkouteren, An K L Reyners, Maureen J B Aarts, Klara Mosterd
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引用次数: 0
摘要
导言:基底细胞癌(BCC)可通过局部手术或非侵入性治疗方式进行治疗。如果 BCC 一直得不到治疗,就可能发展为局部晚期 BCC 或转移性 BCC:在此,我们详细报告了三例复杂晚期BCC(aBCC)在维莫德吉治疗失败后的治疗情况。在个性化癌症治疗中心-02(Center for Personalized Cancer Treatment-02,CPCT-02)研究中对所有肿瘤进行了新一代DNA测序;随后,患者被纳入药物再发现方案(Drug Rediscovery Protocol,DRUP)试验,根据肿瘤分子图谱开始使用市售靶向抗癌药物进行治疗。所有患者在接受二线 PD-1 抑制剂治疗后均出现部分反应或病情稳定,平均反应持续时间为 12.3 个月:讨论/结论:免疫疗法可以作为对刺猬通路抑制剂治疗耐药的 ABCC 的一种治疗选择。然而,尽管 aBCC 的肿瘤突变负荷较高,但免疫疗法并不总能带来长期应答。通过平行或交替循环重新挑战或联合使用刺猬蛋白抑制剂和PD-1抑制剂可能是延长治疗反应的一种策略。
Hedgehog Pathway and Programmed Cell Death Protein-1 Inhibitors for Advanced Basal Cell Carcinoma.
Introduction: Basal cell carcinoma (BCC) is treated with local surgery or noninvasive treatment modalities. If a BCC remains untreated, it can develop into a locally advanced BCC or a metastatic BCC.
Case presentation: Here we report in detail the management of three complex advanced BCC (aBCC) after treatment failure with vismodegib. On all tumors, next generation DNA sequencing in the Center for Personalized Cancer Treatment-02 (CPCT-02) study was performed; subsequently, patients were included in the Drug Rediscovery Protocol (DRUP) trial, in which treatment was started with commercially available targeted anticancer drugs based on the molecular tumor profile. All patients showed partial response or stable disease following treatment with second line PD-1 inhibitors with an average duration of response of 12.3 months.
Discussion/conclusion: Immunotherapy can be a treatment option for aBCC resistant to hedgehog pathway inhibitor treatment. However, despite the high tumor mutational burden of aBCCs, immunotherapy does not always lead to a long response. Rechallenge or combining treatment of hedgehog inhibitors and PD-1 inhibitors by parallel or alternating cycles may be a strategy to lengthen the treatment response.