Long-term survival after combination therapy with atezolizumab in a patient with small-cell lung cancer: a case report

作者：Gao G, Wu Y, Liu Q, Zhai C, Inoue Y, Zhang X, Lv X, Zhang W, Wang J · 发表于：Translational lung cancer research · 年份：2024 · DOI：10.21037/tlcr-24-981 · 被引用次数：55 · 研究领域：Small-cell lung cancer (SCLC)、atezolizumab、case report、long-term survival、radiotherapy

BACKGROUND: Small-cell lung cancer (SCLC) is highly malignant. Despite being highly sensitive to initial chemotherapy and radiotherapy, the recurrence rate is high. Atezolizumab is the first immune checkpoint inhibitor (ICI) that has been proven to provide an overall survival (OS) benefit for extensive-stage SCLC (ES-SCLC), making ICIs in combination with chemotherapy the standard first-line treatment for ES-SCLC. However, the real-world treatment of SCLC is more complex, and multimodal therapy may be needed to achieve long-term patient survival. Few reports on later-line chemotherapy combined with immunotherapy have been published thus far. Moreover, there is limited data on the efficacy and safety of thoracic radiotherapy and radiotherapy for metastatic lesions after multiple lines of treatment have failed in ES-SCLC, and the value of small-molecule antiangiogenesis combined with immunotherapy also needs further exploration. CASE DESCRIPTION: A patient was diagnosed with mediastinal limited-stage SCLC (LS-SCLC) and experienced local progression following standard chemoradiotherapy and prophylactic cranial irradiation. Subsequently, the patient underwent second-line irinotecan chemotherapy, which resulted in severe hematological toxicity. Upon initiation of third-line therapy with anlotinib, the disease remained stable for 9 months. Unfortunately, imaging revealed the presence of a new lesion at the right lung apex. Nevertheless, there was renewed hope for survival when ate...