一例化疗联合免疫治疗无效胰腺癌患者再联合靶向治疗有效  

A case of pancreatic cancer treated with chemotherapy combined with immunotherapy and targeted therapy

作　　者：张波[1] 唐科忠 董鑫[1] ZHANG Bo;TANG Kezhong;DONG Xin(Department of Surgery,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院外科,浙江杭州310009

出　　处：《浙江大学学报（医学版）》2023年第5期578-582,共5页Journal of Zhejiang University(Medical Sciences)

基　　金：国家自然科学基金(81570698)。

摘　　要：一例68岁男性患者因纳差乏力就诊,影像学和肝病灶穿刺活检结果提示胰腺体尾癌伴肝脏多发转移,肿瘤标志物糖类抗原(CA)199为2003.4 U/mL。患者采用改良FOLFIRINOX化疗方案联合免疫检查点抑制剂(派安普利单抗)治疗两周期后胰尾及肝脏肿块未减小,CA199水平较前明显升高。从第三周期加用靶向药物安罗替尼后发现胰腺病灶及肝转移灶较前明显缩小,行腹腔镜下胰体尾切除、脾切除及肝转移灶切除术。患者术后再次行三周期改良FOLFIRINOX联合安罗替尼及派安普利单抗治疗,三周期后采用安罗替尼及派安普利单抗维持治疗,随访患者至今(确诊后近19个月)未见明显复发。A 68-year-old male was admitted due to fatigue and poor appetite and diagnosed pathologically as pancreatic adenocarcinoma with liver metastasis.The tumor marker carbohydrate antigen 199(CA199)level was 2003.4 U/mL.The patient received two cycles of modified FOLFIRINOX plus immune checkpoint inhibitor(penpulimab).However,the tumor did not shrink and CA199 level was even higher.Anlotinib was added from the 3rd cycle,and the size of primary tumor and metastatic lesions were significantly reduced.Laparoscopic distal pancreatectomy and splenectomy as well as liver metastasis resection was performed.Three cycles of combined therapy were adopted after surgery followed by maintenance therapy with anlotinib plus penpulimab.There was no evidence of tumor recurrence during the follow-up(nearly 19 months since diagnosis).

关 键 词：胰腺癌 化疗 靶向治疗 免疫治疗 肿瘤微环境 病例报告 

分 类 号：R735[医药卫生—肿瘤]