PMID- 36111030
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220917
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 10
IP  - 16
DP  - 2022 Aug
TI  - A lung adenocarcinoma patient with ROS1 fusion and NBN germline mutation achieves 
      long progression-free survival from sintilimab combined with niraparib after 
      failure of ROS1 inhibitors: a case report.
PG  - 912
LID - 10.21037/atm-22-3582 [doi]
LID - 912
AB  - BACKGROUND: Lung cancer is a malignant tumor with high morbidity and mortality 
      worldwide. At present, the main treatment methods for patients with advanced 
      non-small cell lung cancer (NSCLC) include molecular targeted therapy and 
      immunotherapy. The efficacy rate of immune checkpoint inhibitor (ICI) monotherapy 
      is relatively low. Studies have confirmed that some combination therapies have 
      better anti-tumor efficacy and higher response rates, such as PD-1/PD-L1 
      inhibitors combined with chemotherapy or targeted therapy. Poly (ADP-ribose) 
      polymerase (PARP) inhibitors have become a new line of cancer therapy in ovarian 
      and breast cancer, but it's not approved in lung cancer. Some reports show that 
      homologous recombination repair (HRR) gene variants may be potential biomarkers 
      for immunotherapy. However, whether lung cancer with HRR gene variants can be 
      benefit from ICIs combined with PARP inhibitors is unknown. CASE DESCRIPTION: We 
      present a case of a 30-year-old man who was admitted to hospital with several 
      months of cough and the chest computed tomography (CT) scan showed a mass about 
      2.6 cm x 2.1 cm in the left lung. Then he was diagnosed with lung adenocarcinoma 
      (LUAD). Next generation sequencing (NGS) revealed that he harbors ROS1 fusion and 
      NBN germline mutation. So, he received platinum-based chemotherapy and ROS1 
      inhibitors, but the disease continued to progress. Ultimately, the patient was 
      switched to sintilimab combined with niraparib and the efficacy was evaluated as 
      stable disease (SD), with a progression-free survival (PFS) of more than 12 
      months, and the overall survival (OS) is 23 months up to now. During the 
      treatment, the major adverse events (AEs) observed were lymphopenia, nausea, 
      vomiting, and edema. The AEs were tolerable. CONCLUSIONS: This case shows that 
      the combination of small-molecule inhibitors and immunotherapy may improve 
      survival in NSCLC patients with driver genes, and sintilimab combined with 
      niraparib provides a successful clinical case for the treatment of refractory 
      tumors HRR gene mutation, which can be used as a reference for personalized 
      treatment. Of course, more clinical trials are needed to confirm this combination 
      treatment strategy.
CI  - 2022 Annals of Translational Medicine. All rights reserved.
FAU - Xu, Fangye
AU  - Xu F
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Xiao, Chunmei
AU  - Xiao C
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Sun, Weijie
AU  - Sun W
AD  - Department of Medicine, Beijing GenePlus Clinical Laboratory Co., Ltd., Beijing, 
      China.
FAU - He, Yuange
AU  - He Y
AD  - Department of Medicine, Beijing GenePlus Clinical Laboratory Co., Ltd., Beijing, 
      China.
FAU - Chalela, Roberto
AU  - Chalela R
AD  - Respiratory Medicine Department, Hospital del Mar, Barcelona, Spain.
AD  - Pompeu Fabra University (UPF), Barcelona, Spain.
AD  - IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
FAU - Masuda, Ken
AU  - Masuda K
AD  - Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
FAU - Ulivi, Paola
AU  - Ulivi P
AD  - Biosciences Laboratory, Istituto Romagnolo per lo Studio dei Tumori "Dino 
      Amadori" IRST-IRCCS, Meldola, Italy.
FAU - Shen, Kai
AU  - Shen K
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Shao, Qianwen
AU  - Shao Q
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Xu, Jiali
AU  - Xu J
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Liu, Lianke
AU  - Liu L
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
LA  - eng
PT  - Case Reports
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC9469170
OTO - NOTNLM
OT  - Lung adenocarcinoma
OT  - ROS1 and NBN
OT  - case report
OT  - niraparib
OT  - sintilimab
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://atm.amegroups.com/article/view/10.21037/atm-22-3582/coif). WS and YH are 
      from Beijing GenePlus Clinical Laboratory Co., Ltd. RC received honoraria as 
      speaker from GlaxoSmithKline, Chiesi and TEVA, not related with the manuscript. 
      KM received honoraria as speaker from ONO, AstraZeneca, Chugai, Bristol Myers 
      Squibb and Healios, not related with the manuscript. The other authors have no 
      conflicts of interest to declare
EDAT- 2022/09/17 06:00
MHDA- 2022/09/17 06:01
PMCR- 2022/08/01
CRDT- 2022/09/16 02:41
PHST- 2022/05/16 00:00 [received]
PHST- 2022/08/02 00:00 [accepted]
PHST- 2022/09/16 02:41 [entrez]
PHST- 2022/09/17 06:00 [pubmed]
PHST- 2022/09/17 06:01 [medline]
PHST- 2022/08/01 00:00 [pmc-release]
AID - atm-10-16-912 [pii]
AID - 10.21037/atm-22-3582 [doi]
PST - ppublish
SO  - Ann Transl Med. 2022 Aug;10(16):912. doi: 10.21037/atm-22-3582.