Cancer Metastases from Lung Adenocarcinoma Disappeared After Molecular Targeted Therapy: A Successfully Clinical Treatment Experience

Case Report: Exploring delayed hyperprogressive disease: a case study of post-immunotherapy in lung cancer

Background

Recent studies have shown that immunotherapy improves survival outcomes for patients with a late staged cancer. However, in a small number of cases do not benefit from this treatment and instead experience rapid tumor progression, known as hyperprogressive disease (HPD). Currently, HPD is provisionally defined as occurring within two months of receiving immunotherapy. Is HPD that occurs after two months associated with immunotherapy? The existing literature does not provide an answer.

Case presentation

A 59-year-old woman was diagnosed with unresectable squamous cell carcinoma of the lung. She received four months (6 cycles) of chemotherapy with albumin-bound paclitaxel and cisplatin, along with immunotherapy using Camrelizumab. After treatment, the lesion in the patient's lung were significantly reduced. However, because the tumor did not disappear and due to the limitations dose of the chemotherapy drugs using for body, the patient turned to receive stereotactic radiation therapy (2 Gy per fraction). After 10 fractions of radiotherapy, the lesion in the patient's lung significantly increased. The enlarged lesion was pathologically analyzed through a percutaneous lung biopsy and was confirmed to be squamous cell carcinoma. Following the cessation of radiotherapy, four cycles of targeted segment arterial chemoembolization resulted in another significant reduction in the lung lesion.

Conclusions

This report is the first to present HPD after 5 months of immunotherapy, marking the longest recorded occurrence of this phenomenon. This particular case of post-immunotherapy HPD achieved satisfactory results through targeted segment arterial chemoembolization, offering a potential approach for managing this side effect.

Interaction between SIRT1 and non-coding RNAs in different disorders

SIRT1 is a member of the sirtuin family functioning in the process of removal of acetyl groups from different proteins. This protein has several biological functions and is involved in the pathogenesis of metabolic diseases, malignancy, aging, neurodegenerative disorders and inflammation. Several long non-coding RNAs (lncRNAs), microRNAs (miRNAs) and circular RNAs (circRNAs) have been found to interact with SIRT1. These interactions have been assessed in the contexts of sepsis, cardiomyopathy, heart failure, non-alcoholic fatty liver disease, chronic hepatitis, cardiac fibrosis, myocardial ischemia/reperfusion injury, diabetes, ischemic stroke, immune-related disorders and cancers. Notably, SIRT1-interacting non-coding RNAs have been found to interact with each other. Several circRNA/miRNA and lncRNA/miRNA pairs that interact with SIRT1 have been identified. These axes are potential targets for design of novel therapies for different disorders. In the current review, we summarize the interactions between three classes of non-coding RNAs and SIRT1.

Case report: A case of acute mastitis associated with reactive cutaneous capillary endothelial proliferation after camrelizumab treatment: A new immune-related adverse event

Lung cancer is a malignant tumor with the highest morbidity and mortality rate worldwide, and it seriously endangers human health. In recent years, immunotherapy has been widely used in lung cancer and has achieved great benefits, especially the application of promoting antitumor immune defense. However, immune-related adverse events (irAEs) caused by immune checkpoint inhibitors have received increasing attention, which largely limits their use. We report the first case of new acute mastitis caused by anti-PD1 inhibitors due to lung adenocarcinoma. A 65-year-old female patient came to our hospital for treatment with cough and shortness of breath for one month. Chest CT showed that the malignant tumor in the lower lobe of the right lung with pleural effusion had metastasized to many places, and then pleural effusion was taken for pathological examination. Pathological examination indicated that the pleural fluid originated from lung adenocarcinoma. Subsequently, the patient received platinum-containing dual-agent chemotherapy (carboplatin and pemetrexed disodium) combined with immunotherapy (camrelizumab). During treatment, the patient developed known adverse events and unreported acute mastitis. After stopping camrelizumab, the patient’s mastitis gradually improved. Our case shows that acute mastitis might be a new adverse event after the use of camrelizumab. Since this new adverse event has not been reported, we hope that oncology medical workers can obtain insight from our case and use it as a reference for the identification and management of irAEs.