多模式治疗包括免疫治疗和维持PARP抑制剂治疗子宫内膜癌IVC期完全缓解- 1例报告

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2025-05-01 DOI:10.1016/j.tjog.2024.12.027

You-Yan Chen , Feng-Yuan Liu , Yin-Yin Chiang , Chyong-Huey Lai

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引用次数: 0

摘要

目的偶有免疫检查点抑制剂（ici）治疗IVC期子宫内膜癌（EC）的报道。我们提出一个长期生存的MMR熟练（MMRp）病例。病例报告：患者诊断为EC（子宫内膜样病变，3级，MMRp，程序性死亡配体1阳性）IVC期（肺、脊柱/骨盆骨、主动脉旁、骨盆、腹股沟和骶前淋巴结转移），肿瘤从子宫内膜扩展到子宫颈、阴道到外阴。在对紫杉醇/卡铂、阿霉素/卡铂脂质体、派姆单抗和骨盆/盆腔骨转移放疗的化疗免疫治疗有反应后，患者接受了明确的手术，仅显示残留的EC。奥拉帕尼作为维持治疗。2.5年后患者骶前淋巴结孤立复发，经质子治疗后再次完全缓解，并给予奥拉帕尼维持。复发31个月后，目前无病。结论早期IVC MMRp EC经包括ICI在内的综合治疗仍有可能治愈复发。

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Complete remission of endometrial cancer stage IVC treated with multimodality treatment including immunotherapy and maintenance PARP inhibitor – A case report

Objective

Mismatched repair (MMR) deficient, stage IVC endometrial carcinoma (EC) are occasionally reported as cured by immune-checkpoint inhibitors (ICIs). We present an MMR proficient (MMRp) case with long-term survival.

Case report

The patient was diagnosed with EC (endometrioid, grade 3, MMRp, programmed death-ligand 1 positive) stage IVC (lung, spine/pelvic bone, paraaortic, pelvic, inguinal and presacral node metastases) with tumor extended from endometrium to cervix, vagina to vulva. After responded to chemoimmunotherapy with paclitaxel/carboplatin then liposomal doxorubicin/carboplatin, pembrolizumab and radiotherapy to pelvis/pelvic bone metastasis, the patient received definitive surgery which showed only residual EC. Olaparib was used as maintenance therapy. The patient developed isolated recurrence in presacral lymph node 2.5 years later, she underwent proton therapy and got complete remission again and maintained with olaparib. She is currently without disease 31 months since recurrence.

Conclusion

Initial stage IVC MMRp EC with recurrence is still potentially curable with multimodality treatment including ICI.

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.