Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Лечение распространенного мелкоклеточного рака легкого. Клинический случай и обзор литературы
Меньшиков К.В., Султанбаев А.В., Мусин Ш.И., Меньшикова И.А., Насретдинов А.Ф., Султанбаева Н.И. Лечение распространенного мелкоклеточного рака легкого. Клинический случай и обзор литературы. Современная Онкология. 2021; 23 (1): 112–115. DOI: 10.26442/18151434.2021.1.200726
________________________________________________
Menshikov KV, Sultanbaev AV, Musin ShI, Menshikova IA, Nasretdinov AF, Sultanbaeva NI. Treatment of advanced small cell lung cancer. Clinical case and literature review Journal of Modern Oncology. 2021; 23 (1): 112–115.
DOI: 10.26442/18151434.2021.1.200726
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Рак легкого – одна из самых распространенных опухолей человека. Заболеваемость находится на одной из ведущих позиций. В 2019 г. в Республике Башкортостан было выявлено 1327 пациентов с этой патологией, из них с III стадией заболевания – 28,7%, с IV стадией – 45,8%. Мелкоклеточный рак легкого (МРЛ) – одна из самых прогностически неблагоприятных злокачественных опухолей человека. Примерно 15% опухолей легкого составляет МРЛ. Первой комбинацией для лечения распространенного МРЛ после этопозида и препаратов платины стала комбинация режима этопозид + карбоплатин (ЕР) с атезолизумабом. В исследовании IMpower133 при медиане наблюдения в 13,9 мес медиана общей выживаемости в группе атезолизумаба составила 12,3 мес, а в группе плацебо – 10,3 мес. В клиническом наблюдении продемонстрирована эффективность комбинации режима ЕР с атезолизумабом. Пациент с МРЛ получил 4 курса терапии в режиме ЕР с атезолизумабом и 14 введений атезолизумаба. Достигнутый частичный ответ сохраняется. Клинический случай демонстрирует эффективность и удовлетворительный профиль безопасности комбинации атезолизумаба и режима ЕР.
Ключевые слова: мелкоклеточный рак легкого, иммунотерапия, химиотерапия, атезолизумаб, IMpower133, общая выживаемость
Ключевые слова: мелкоклеточный рак легкого, иммунотерапия, химиотерапия, атезолизумаб, IMpower133, общая выживаемость
________________________________________________
Lung cancer is one of the most common tumors in humans. The incidence is in one of the leading positions. In 2019 1327 patients with this pathology were identified in the Republic of Bashkortostan. Of these, with stage III of the disease – 28.7%, with stage IV 45.8%, which is higher. Small cell lung cancer (SCLC) is one of the most prognostically unfavorable malignant tumors in humans. About 15% of lung tumors are SCLC. The first combination for the treatment of advanced SCLC after etoposide and platinum preparations was the combination of the etoposide + carboplatin (EP) regimen with atezolizumab. In the IMpower133 study, after a median follow-up of 13.9 months. median overall survival in the atezolizumab group was 12.3 months, and in the placebo group – 10.3 months. In clinical observation, the effectiveness of the combination of the EP regimen with atezolizumab has been demonstrated. A patient with SCLC received 4 courses of EP therapy with atezolizumab and 14 injections of atezolizumab. The partial response achieved is retained. Case study efficacy and satisfactory safety profile of the combination of atezolizumab and the EP regimen.
Keywords: small cell lung cancer, immunotherapy, chemotherapy, atezolizumab, IMpower133, overall survival
Полный текст
Список литературы
1. Состояние онкологической помощи населению России в 2019 году. Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2020 [The state of cancer care for the population of Russia in 2019. Ed. AD Kaprina, VV Starinsky, AO Shahzadova. Moscow: MNIOI im. PA Herzena – filial FGBU "NMITs radiologii' Minzdrava Rossii, 2020 (in Russian)].
2. Young MR. Th17 Cells in Protection fr om Tumor or Promotion of Tumor Progression. J Clin Cell Immunol 2016; 7 (3): 431.
3. Peifer M, Fernández-Cuesta L, Sos ML, et al. Integrative genome analyses identify key somatic driver mutations of small-cell lung cancer. Nat Genet 2012; 44: 1104. DOI: 10.1038/ng.2396
4. Sultanbaev A, Nasretdinov A, Sultanbaeva N, et al. 12P EGFR gene mutations landscape at lung cancer in a multinational region located in the southeast of the European part of Russia. Ann Oncol 2020; 31 (Suppl. 5): S1220–1221. DOI: 10.1016/j.annonc.2020.08.2171
5. Alvarado-Luna G, Morales-Espinosa D. Treatment for small cell lung cancer, wh ere are we now? Transl Lung Cancer Res. 2016;5(1): 26-38. DOI: 10.3978/j.issn.2218-6751.2016.01.13.
6. NCCN clinical practice guidelines in oncology: small cell lung cancer, version 2.2018. Available at: https://www.nccn.org/about/news/ebulletin/ebulletindetail.aspx?ebulletinid=1318
7. Stahel R, Thatcher N, Früh M, et al. 1st ESMO Consensus Conference in lung cancer; Lugano 2010: small-cell lung cancer. Ann Oncol 2011; 22: 1973–80.
8. Farago AF, Keane FK. Current standards for clinical management of small cell lung cancer. Transl Lung Cancer Res 2018; 7: 69–79.
9. Socinski MA, Smit EF, Lorigan P, et al. Phase III study of pemetrexed plus carboplatin compared with etoposide plus carboplatin in chemotherapy-naive patients with extensive-stage small-cell lung cancer. J Clin Oncol 2009; 27: 4787–92.
10. Lopez-Chavez A, Sandler A. Systemic Issues in Small Cell Lung Cancer. Curr Probl Cancer 2012 May-Jun; 36(3): 131–55. DOI: 10.1016/j.currproblcancer.2012.03.004.11
11. Darnell RB. Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain. Proc Natl Acad Sci USA 1996; 93 (10): 4529–36.
12. Насретдинов А.Ф., Султанбаева Н.И., Мусин Ш.И., и др. Уровень опухоль-инфильтрирующих лимфоцитов и PD-статус как возможные прогностические маркеры выживаемости и эффективности терапии при трижды негативном раке молочной железы. Опухоли женской репродуктивной системы. 2020; 16 (1): 65–70 [Nasretdinov AF, Sultanbaeva NI, Musin ShI, et al. Uroven' opukhol'-infil'triruiushchikh limfotsitov i PD-status kak vozmozhnye prognosticheskie markery vyzhivaemosti i effektivnosti terapii pri trizhdy negativnom rake molochnoi zhelezy. Opukholi zhenskoi reproduktivnoi sistemy. 2020; 16 (1): 65–70 (in Russian)]. DOI: 10.17650/1994-4098-2020-16-1-65-70
13. Antonia SJ, López-Martin JA, Bendell J, et al. Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): a multicentre, open-label, phase 1/2 trial. Lancet Oncol 2016; 17: 883–95.
14. Ott PA, Elez E, Hiret S, et al. Pembrolizumab in patients with extensive-stage small-cell lung cancer: results from the Phase Ib KEYNOTE-028 study. J Clin Oncol 2017; 35: 3823–9.
15. Sequist LV, Chiang A, Gilbert J, et al. Clinical activity, safety and predictive biomarkers results from a phase Ia atezolizumab (atezo) trial in extensive-stage small cell lung cancer (ES-SCLC). Ann Oncol 2016; 27 (Suppl. 6): 1425PD.
16 Diaz LA, Marabelle A, Delord J, et al. Pembrolizumab therapy for microsatellite instability high (MSI-H) colorectal cancer (CRC) and non-CRC. J Clin Oncol 2017; 35 (Suppl. 3071).
17. Gadgeel SM, Pennell NA, Fidler MJ, et al. Phase II study of maintenance pembrolizumab in patients with extensivestage small cell lung cancer (SCLC). J Thorac Oncol 2018; 13: 1393–9.
18. Reck M, Luft A, Szczesna A, et al. Phase III randomized trial of ipilimumab plus etoposide and platinum versus placebo plus etoposide and platinum in extensive-stage small-cell lung cancer. J Clin Oncol 2016; 34: 3740–8.
19. Horn L, Mansfeld AS, Szczęsna A, et al. First-line atezolizumab plus chemotherapy in extensive stage small-cell lung cancer. N Engl J Med 2018; 379: 2220–9.
20. Кузьминов А.Е., Лактионов К.К., Егорова А.В., и др. Иммунотерапия мелкоклеточного рака легкого. Медицинский совет. 2019; 10: 22–7 [Kuz'minov AE, Laktionov KK, Egorova AV, et al. Immunoterapiia melkokletochnogo raka legkogo. Meditsinskii sovet. 2019; 10: 22–7 (in Russian)]. DOI: 10.21518/2079-701X-2019-10-22-27
21. Liu SV, Reck M, Mansfield AS, et al. Updated Overall Survival and PD-L1 Subgroup Analysis of Patients With Extensive-Stage Small-Cell Lung Cancer Treated With Atezolizumab, Carboplatin, and Etoposide (IMpower133). J Clin Oncol 2021; 39 (6): 619–30.
2. Young MR. Th17 Cells in Protection fr om Tumor or Promotion of Tumor Progression. J Clin Cell Immunol 2016; 7 (3): 431.
3. Peifer M, Fernández-Cuesta L, Sos ML, et al. Integrative genome analyses identify key somatic driver mutations of small-cell lung cancer. Nat Genet 2012; 44: 1104. DOI: 10.1038/ng.2396
4. Sultanbaev A, Nasretdinov A, Sultanbaeva N, et al. 12P EGFR gene mutations landscape at lung cancer in a multinational region located in the southeast of the European part of Russia. Ann Oncol 2020; 31 (Suppl. 5): S1220–1221. DOI: 10.1016/j.annonc.2020.08.2171
5. Alvarado-Luna G, Morales-Espinosa D. Treatment for small cell lung cancer, wh ere are we now? Transl Lung Cancer Res. 2016;5(1): 26-38. DOI: 10.3978/j.issn.2218-6751.2016.01.13.
6. NCCN clinical practice guidelines in oncology: small cell lung cancer, version 2.2018. Available at: https://www.nccn.org/about/news/ebulletin/ebulletindetail.aspx?ebulletinid=1318
7. Stahel R, Thatcher N, Früh M, et al. 1st ESMO Consensus Conference in lung cancer; Lugano 2010: small-cell lung cancer. Ann Oncol 2011; 22: 1973–80.
8. Farago AF, Keane FK. Current standards for clinical management of small cell lung cancer. Transl Lung Cancer Res 2018; 7: 69–79.
9. Socinski MA, Smit EF, Lorigan P, et al. Phase III study of pemetrexed plus carboplatin compared with etoposide plus carboplatin in chemotherapy-naive patients with extensive-stage small-cell lung cancer. J Clin Oncol 2009; 27: 4787–92.
10. Lopez-Chavez A, Sandler A. Systemic Issues in Small Cell Lung Cancer. Curr Probl Cancer 2012 May-Jun; 36(3): 131–55. DOI: 10.1016/j.currproblcancer.2012.03.004.11
11. Darnell RB. Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain. Proc Natl Acad Sci USA 1996; 93 (10): 4529–36.
12. Насретдинов А.Ф., Султанбаева Н.И., Мусин Ш.И., и др. Уровень опухоль-инфильтрирующих лимфоцитов и PD-статус как возможные прогностические маркеры выживаемости и эффективности терапии при трижды негативном раке молочной железы. Опухоли женской репродуктивной системы. 2020; 16 (1): 65–70 [Nasretdinov AF, Sultanbaeva NI, Musin ShI, et al. Uroven' opukhol'-infil'triruiushchikh limfotsitov i PD-status kak vozmozhnye prognosticheskie markery vyzhivaemosti i effektivnosti terapii pri trizhdy negativnom rake molochnoi zhelezy. Opukholi zhenskoi reproduktivnoi sistemy. 2020; 16 (1): 65–70 (in Russian)]. DOI: 10.17650/1994-4098-2020-16-1-65-70
13. Antonia SJ, López-Martin JA, Bendell J, et al. Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): a multicentre, open-label, phase 1/2 trial. Lancet Oncol 2016; 17: 883–95.
14. Ott PA, Elez E, Hiret S, et al. Pembrolizumab in patients with extensive-stage small-cell lung cancer: results from the Phase Ib KEYNOTE-028 study. J Clin Oncol 2017; 35: 3823–9.
15. Sequist LV, Chiang A, Gilbert J, et al. Clinical activity, safety and predictive biomarkers results from a phase Ia atezolizumab (atezo) trial in extensive-stage small cell lung cancer (ES-SCLC). Ann Oncol 2016; 27 (Suppl. 6): 1425PD.
16 Diaz LA, Marabelle A, Delord J, et al. Pembrolizumab therapy for microsatellite instability high (MSI-H) colorectal cancer (CRC) and non-CRC. J Clin Oncol 2017; 35 (Suppl. 3071).
17. Gadgeel SM, Pennell NA, Fidler MJ, et al. Phase II study of maintenance pembrolizumab in patients with extensivestage small cell lung cancer (SCLC). J Thorac Oncol 2018; 13: 1393–9.
18. Reck M, Luft A, Szczesna A, et al. Phase III randomized trial of ipilimumab plus etoposide and platinum versus placebo plus etoposide and platinum in extensive-stage small-cell lung cancer. J Clin Oncol 2016; 34: 3740–8.
19. Horn L, Mansfeld AS, Szczęsna A, et al. First-line atezolizumab plus chemotherapy in extensive stage small-cell lung cancer. N Engl J Med 2018; 379: 2220–9.
20. Кузьминов А.Е., Лактионов К.К., Егорова А.В., и др. Иммунотерапия мелкоклеточного рака легкого. Медицинский совет. 2019; 10: 22–7 [Kuz'minov AE, Laktionov KK, Egorova AV, et al. Immunoterapiia melkokletochnogo raka legkogo. Meditsinskii sovet. 2019; 10: 22–7 (in Russian)]. DOI: 10.21518/2079-701X-2019-10-22-27
21. Liu SV, Reck M, Mansfield AS, et al. Updated Overall Survival and PD-L1 Subgroup Analysis of Patients With Extensive-Stage Small-Cell Lung Cancer Treated With Atezolizumab, Carboplatin, and Etoposide (IMpower133). J Clin Oncol 2021; 39 (6): 619–30.
________________________________________________
1. The state of cancer care for the population of Russia in 2019. Ed. AD Kaprina, VV Starinsky, AO Shahzadova. Moscow: MNIOI im. PA Herzena – filial FGBU "NMITs radiologii' Minzdrava Rossii, 2020 (in Russian)
2. Young MR. Th17 Cells in Protection fr om Tumor or Promotion of Tumor Progression. J Clin Cell Immunol 2016; 7 (3): 431.
3. Peifer M, Fernández-Cuesta L, Sos ML, et al. Integrative genome analyses identify key somatic driver mutations of small-cell lung cancer. Nat Genet 2012; 44: 1104. DOI: 10.1038/ng.2396
4. Sultanbaev A, Nasretdinov A, Sultanbaeva N, et al. 12P EGFR gene mutations landscape at lung cancer in a multinational region located in the southeast of the European part of Russia. Ann Oncol 2020; 31 (Suppl. 5): S1220–1221. DOI: 10.1016/j.annonc.2020.08.2171
5. Alvarado-Luna G, Morales-Espinosa D. Treatment for small cell lung cancer, wh ere are we now? Transl Lung Cancer Res. 2016;5(1): 26-38. DOI: 10.3978/j.issn.2218-6751.2016.01.13.
6. NCCN clinical practice guidelines in oncology: small cell lung cancer, version 2.2018. Available at: https://www.nccn.org/about/news/ebulletin/ebulletindetail.aspx?ebulletinid=1318
7. Stahel R, Thatcher N, Früh M, et al. 1st ESMO Consensus Conference in lung cancer; Lugano 2010: small-cell lung cancer. Ann Oncol 2011; 22: 1973–80.
8. Farago AF, Keane FK. Current standards for clinical management of small cell lung cancer. Transl Lung Cancer Res 2018; 7: 69–79.
9. Socinski MA, Smit EF, Lorigan P, et al. Phase III study of pemetrexed plus carboplatin compared with etoposide plus carboplatin in chemotherapy-naive patients with extensive-stage small-cell lung cancer. J Clin Oncol 2009; 27: 4787–92.
10. Lopez-Chavez A, Sandler A. Systemic Issues in Small Cell Lung Cancer. Curr Probl Cancer 2012 May-Jun; 36(3): 131–55. DOI: 10.1016/j.currproblcancer.2012.03.004.11
11. Darnell RB. Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain. Proc Natl Acad Sci USA 1996; 93 (10): 4529–36.
12. Nasretdinov AF, Sultanbaeva NI, Musin ShI, et al. Uroven' opukhol'-infil'triruiushchikh limfotsitov i PD-status kak vozmozhnye prognosticheskie markery vyzhivaemosti i effektivnosti terapii pri trizhdy negativnom rake molochnoi zhelezy. Opukholi zhenskoi reproduktivnoi sistemy. 2020; 16 (1): 65–70 (in Russian)
DOI: 10.17650/1994-4098-2020-16-1-65-70
13. Antonia SJ, López-Martin JA, Bendell J, et al. Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): a multicentre, open-label, phase 1/2 trial. Lancet Oncol 2016; 17: 883–95.
14. Ott PA, Elez E, Hiret S, et al. Pembrolizumab in patients with extensive-stage small-cell lung cancer: results from the Phase Ib KEYNOTE-028 study. J Clin Oncol 2017; 35: 3823–9.
15. Sequist LV, Chiang A, Gilbert J, et al. Clinical activity, safety and predictive biomarkers results from a phase Ia atezolizumab (atezo) trial in extensive-stage small cell lung cancer (ES-SCLC). Ann Oncol 2016; 27 (Suppl. 6): 1425PD.
16 Diaz LA, Marabelle A, Delord J, et al. Pembrolizumab therapy for microsatellite instability high (MSI-H) colorectal cancer (CRC) and non-CRC. J Clin Oncol 2017; 35 (Suppl. 3071).
17. Gadgeel SM, Pennell NA, Fidler MJ, et al. Phase II study of maintenance pembrolizumab in patients with extensivestage small cell lung cancer (SCLC). J Thorac Oncol 2018; 13: 1393–9.
18. Reck M, Luft A, Szczesna A, et al. Phase III randomized trial of ipilimumab plus etoposide and platinum versus placebo plus etoposide and platinum in extensive-stage small-cell lung cancer. J Clin Oncol 2016; 34: 3740–8.
19. Horn L, Mansfeld AS, Szczęsna A, et al. First-line atezolizumab plus chemotherapy in extensive stage small-cell lung cancer. N Engl J Med 2018; 379: 2220–9.
20. Kuz'minov AE, Laktionov KK, Egorova AV, et al. Immunoterapiia melkokletochnogo raka legkogo. Meditsinskii sovet. 2019; 10: 22–7 (in Russian)
DOI: 10.21518/2079-701X-2019-10-22-27
21. Liu SV, Reck M, Mansfield AS, et al. Updated Overall Survival and PD-L1 Subgroup Analysis of Patients With Extensive-Stage Small-Cell Lung Cancer Treated With Atezolizumab, Carboplatin, and Etoposide (IMpower133). J Clin Oncol 2021; 39 (6): 619–30.
Авторы
К.В. Меньшиков*1,2, А.В. Султанбаев1, Ш.И. Мусин1, И.А. Меньшикова2, А.Ф. Насретдинов1, Н.И. Султанбаева1
1 ГАУЗ «Республиканский клинический онкологический диспансер» Минздрава Республики Башкортостан, Уфа, Россия;
2 ФГБОУ «Башкирский государственный медицинский университет» Минздрава России, Уфа, Россия
*kmenshikov80@bk.ru
1 ГАУЗ «Республиканский клинический онкологический диспансер» Минздрава Республики Башкортостан, Уфа, Россия;
2 ФГБОУ «Башкирский государственный медицинский университет» Минздрава России, Уфа, Россия
*kmenshikov80@bk.ru
________________________________________________
Konstantin V. Menshikov*1,2, Aleksandr V. Sultanbaev1, Shamil I. Musin1, Irina A. Menshikova2, Ainur F. Nasretdinov1, Nadezda I. Sultanbaeva1
1 Republican Clinical Oncological Dispensary, Ufa, Russia;
2 Bashkir State Medical University, Ufa, Russia
*kmenshikov80@bk.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.