Successful treatment with nivolumab for SMARCA4-deficient non-small cell lung carcinoma with a high tumor mutation burden: A case report

被引：79

作者：

Naito, Tomoyuki ^{[1
]}

Umemura, Shigeki ^{[1
]}

Nakamura, Hiroshi ^{[2
]}

Zenke, Yoshitaka ^{[1
]}

Udagawa, Hibiki ^{[1
]}

Kirita, Keisuke ^{[1
]}

Matsumoto, Shingo ^{[1
]}

Yoh, Kiyotaka ^{[1
]}

Niho, Seiji ^{[1
]}

Motoi, Noriko ^{[3
]}

Aokage, Keijyu ^{[4
]}

Tsuboi, Masahiro ^{[4
]}

Ishii, Genichiro ^{[2
]}

Goto, Koichi ^{[1
]}

机构：

[1] Natl Canc Ctr Hosp East, Dept Thorac Oncol, 6-5-1 Kashiwanoha, Kashiwa, Chiba 2778577, Japan

[2] Natl Canc Ctr Hosp East, Div Pathol, Kashiwa, Chiba, Japan

[3] Natl Canc Ctr, Dept Pathol & Clin Labs, Tokyo, Japan

[4] Natl Canc Ctr Hosp East, Div Thorac Surg, Kashiwa, Chiba, Japan

来源：

THORACIC CANCER | 2019年 / 10卷 / 05期

基金：

日本学术振兴会;

关键词：

Nivolumab; NSCLC; PD-1; antibody; SMARCA4; SWI; SNF complex; PD-1; BLOCKADE; CANCER; DEFICIENCY;

D O I：

10.1111/1759-7714.13070

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

SMARCA4 is a subunit of the switch/sucrose non-fermentable (SWI/SNF) chromatin-remodeling complex. An effective treatment for SMARCA4-deficient non-small cell lung carcinoma (NSCLC) has not yet been established. Correlations between a response to immune checkpoint inhibitors and the SWI/SNF complex have been suggested, but little is known about the efficacy of immune checkpoint inhibitors against SMARCA4-deficient NSCLC. A 43-year-old man underwent left upper lobe lung resection and was diagnosed with SMARCA4-deficient lung adenocarcinoma. Two months after surgery, multiple lung metastases appeared. Immunohistochemical analysis showed no PD-L1 expression. Whole-exon sequencing revealed a relatively high tumor mutation burden at 396. After the failure of three standard chemotherapy regimens, the patient was treated with nivolumab as fourth-line treatment. An obvious reduction in the lung metastases was obtained for more than 14 months. We report the first case of SMARCA4-deficient NSCLC with a high tumor mutation burden successfully treated with nivolumab. Anti-PD-1 antibodies might be a promising treatment strategy for patients with SMARCA4-deficient NSCLC.

引用

页码：1285 / 1288

页数：4

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