期刊
FRONTIERS IN ONCOLOGY
卷 13, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2023.1103512
关键词
anlotinib; atezolizumab; small-cell lung cancer; HBsAb level; HBV functional cure
类别
Small-cell lung cancer (SCLC) is a poorly differentiated neuroendocrine tumor with endocrine function. Chemotherapy and immune checkpoint inhibitors (ICIs) are the first-line treatment options, but ICIs can cause immune-related side effects in patients with chronic HBV infection. This case study presents a HBsAg-negative patient with increased HBsAb levels after receiving atezolizumab immunotherapy, indicating a potential solution for insufficient antibody production and therapeutic opportunity for HBV patients with cancers.
Small-cell lung cancer (SCLC) is a poorly differentiated neuroendocrine tumor with endocrine function. For decades, chemotherapy and immune checkpoint inhibitors (ICIs) have been the first-line treatment options. Because of its ability to normalize tumor vessels, anlotinib is recommended as a novel therapy as a third-line treatment. A combination of anti-angiogenic drugs and ICIs can effectively and safely benefit advanced cancer patients. However, immune-related side effects caused by ICIs are common. Hepatitis B virus (HBV) reactivation and hepatitis are common during immunotherapy in patients with chronic HBV infection. A 62-year-old man with ES-SCLC who had brain metastasis was described in this case. It is unusual for a HBsAg-negative patient to develop an increase in HBsAb after receiving atezolizumab immunotherapy. Although some researchers have reported the functional cure of HBV by PD-L1 antibody, this is the first case that showed a sustained increased in HBsAb level after anti-PD-L1 therapy. It is related with CD4+ and CD8+ T cells activation and HBV infection microenvironment. Importantly, this could provide a solution to insufficient protective antibody production after vaccination as well as a therapeutic opportunity for HBV patients with cancers.
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