内容紹介
Summary
The option of chemotherapy for recurrent thymoma is limited. Postoperative adjuvant therapy has yet to be established. A 71—year—old male underwent extended thymectomy for thymoma with Masaoka stage Ⅲ, and subsequently, radiation was performed as adjuvant therapy in 2012. Since recurrence was detected in 2014, multidisciplinary treatment was performed for 4 years. An increase of intrathoracic dissemination was detected in 2018. Tumor tissue samples by re—biopsy showed 70% expression of programmed death—ligand 1(PD—L1). Pembrolizumab was administered as fifth—line chemotherapy every 4 weeks at a dosage of 200 mg. After 3 courses, the lesions had remarkably decreased. This suggests that pembrolizumab for thymoma with high PD—L1 expression is efficacious.
要旨
再発胸腺腫に対する化学療法の選択肢は限定されており,手術後の補助治療についても確立されたものがない。症例は71歳,男性。2012年に正岡Ⅲ期胸腺腫に対し拡大胸腺摘出術を行い,術後放射線療法を行った。2014年に再発を認め,以後4年間にわたって集学的治療を行ったが2018年に胸腔内播種の増大を認めた。再生検の結果,PD—L1 tumor proportion score(TPS)の70%発現がみられた。五次化学療法としてpembrolizumabを200 mg/body,4週間隔で3コース投与したところ病変の著明な縮小を認めた。PD—L1高発現を呈する胸腺腫に対し,pembrolizumabの有効性が示唆された症例を報告する。
目次
The option of chemotherapy for recurrent thymoma is limited. Postoperative adjuvant therapy has yet to be established. A 71—year—old male underwent extended thymectomy for thymoma with Masaoka stage Ⅲ, and subsequently, radiation was performed as adjuvant therapy in 2012. Since recurrence was detected in 2014, multidisciplinary treatment was performed for 4 years. An increase of intrathoracic dissemination was detected in 2018. Tumor tissue samples by re—biopsy showed 70% expression of programmed death—ligand 1(PD—L1). Pembrolizumab was administered as fifth—line chemotherapy every 4 weeks at a dosage of 200 mg. After 3 courses, the lesions had remarkably decreased. This suggests that pembrolizumab for thymoma with high PD—L1 expression is efficacious.
要旨
再発胸腺腫に対する化学療法の選択肢は限定されており,手術後の補助治療についても確立されたものがない。症例は71歳,男性。2012年に正岡Ⅲ期胸腺腫に対し拡大胸腺摘出術を行い,術後放射線療法を行った。2014年に再発を認め,以後4年間にわたって集学的治療を行ったが2018年に胸腔内播種の増大を認めた。再生検の結果,PD—L1 tumor proportion score(TPS)の70%発現がみられた。五次化学療法としてpembrolizumabを200 mg/body,4週間隔で3コース投与したところ病変の著明な縮小を認めた。PD—L1高発現を呈する胸腺腫に対し,pembrolizumabの有効性が示唆された症例を報告する。