非小细胞肺癌（NSCLC）占全球肺癌病例的大部分。脑转移 (BM) 经常使 NSCLC 复杂化并预示着不良的预后。为了控制神经系统症状，手术切除后通常进行脑部放射治疗（RT）。然而，放疗常常因神经毒性而变得复杂。对于携带阳性驱动基因的肿瘤患者，酪氨酸激酶抑制剂被认为是标准治疗方法。尽管如此，对于那些没有驱动基因突变的人的治疗选择仍然存在争议。程序性死亡受体 1 (PD-1)/配体 1 (PD-L1) 抑制已成为治疗 PD-L1 阳性肿瘤的 NSCLC 患者以及无症状 BM 患者的一种新型治疗策略。然而，抗 PD-1 抗体对此类特定人群中活性 BM 的影响尚未确定。在此，我们介绍一例 65 岁 NSCLC 和高 PD-L1 表达 BM 患者的病例。该患者接受了 BM 手术切除，随后接受 31 个周期的 zimberelimab（一种新型抗 PD-1 抗体）一线单药治疗，并已实现 24 个月的无进展生存期和颅内无复发生存期。据我们所知，这是第一份关于 zimberelimab 对原发性肺癌 BM 的颅内影响的报告。本病例报告可能有助于了解不同抗 PD-1 抗体对此类人群的颅内影响。版权所有 © 2024 Wu、Guo、He、Deng 和 Huang。

Non-small cell lung cancer (NSCLC) accounted for the majority of lung cancer cases worldwide. Brain metastases (BM) frequently complicate NSCLC and portend a dismal prognosis. To control neurological symptoms, surgical resection is commonly followed by brain radiotherapy (RT). However, RT is often complicated by neurotoxicity. For patients with tumors that harbor positive driver genes, tyrosine kinase inhibitors are considered the standard of care. Nevertheless, treatment options for those without driver gene mutations are still debated. Programmed death receptor 1 (PD-1)/ligand 1 (PD-L1) inhibition has emerged as a novel therapeutic strategy for NSCLC patients with PD-L1-positive tumors, as well as for those with asymptomatic BM. However, the effect of anti-PD-1 antibodies on active BM within such specific populations is undetermined. Herein we present a case of a 65-year-old patient with NSCLC and high PD-L1-expressing BM. The patient underwent surgical resection of BM followed by first-line monotherapy with 31 cycles of zimberelimab, a novel anti-PD-1 antibody, and has already achieved 24 months of progression-free survival and intracranial recurrence-free survival. To our knowledge, this is the first report regarding the intracranial effect of zimberelimab on BM from primary lung cancer. This case report might facilitate an understanding of the intracranial effects of different anti-PD-1 antibodies for such populations.Copyright © 2024 Wu, Guo, He, Deng and Huang.