https://doi.org/10.4081/monaldi.2022.2440
Complete response to pembrolizumab as a single agent in a patient with stage III NSCLC with high PD-L1 expression: a case report
Submitted: September 27, 2022
Accepted: November 14, 2022
Published: November 25, 2022
Accepted: November 14, 2022
Abstract Views: 1183
PDF: 301
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Non‐small cell lung cancer (NSCLC) accounts for 75-80% of all lung cancer cases. Stage III NSCLC represents a highly heterogenous stage characterized by different disease presentations and a wide range of treatment options. For patients with good performance status and unresectable-stage III NSCLC with programmed death-ligands 1 (PD-L1) tumor proportion score (TPS) ≥1%, durvalumab consolidation immunotherapy after a platinum-based chemo-radiotherapy is strongly recommended. However, age, poor performance status, underlying comorbidities may represent contraindications for chemotherapy to be used in a subgroup of patients. Herein, we report a case of an 80-year-old male affected by a stage IIIB lung adenocarcinoma with overexpression of PD-L1 (TPS 90%) treated with pembrolizumab, an immune checkpoint inhibitor targeting PD-1/PD-L1 pathways, which shows a complete resolution of lung lesion after four cycles of treatment. Although randomized controlled trials are required, this case report may suggest the potential role of pembrolizumab for chemotherapy unsuitable patients with overexpressing PD-L1 unresectable-stage III NSCLC.
Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209-49.
DOI: https://doi.org/10.3322/caac.21660
Okawara G, Mackay JA, Evans WK, Ung YC. Management of unresected stage III non-small cell lung cancer: A systematic review. J Thorac Oncol 2006;1:377–93.
DOI: https://doi.org/10.1016/S1556-0864(15)31598-7
Perrotta F, Nankivell M, Adizie B, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for PD-L1 testing in non-small cell lung cancer. Chest 2020;158:1230-9.
DOI: https://doi.org/10.1016/j.chest.2020.04.059
Evison M. The current treatment landscape in the UK for stage III NSCLC. Br J Cancer 2020;123:3–9.
DOI: https://doi.org/10.1038/s41416-020-01069-z
Käsmann L, Eze C, Taugner J, et al. Chemoradioimmunotherapy of inoperable stage III non-small cell lung cancer: Immunological rationale and current clinical trials establishing a novel multimodal strategy. Radiat Oncol 2020;15:1-14.
DOI: https://doi.org/10.1186/s13014-020-01595-3
Komici K, Bencivenga L, Navani N, et al. Frailty in patients with lung cancer: a systematic review and meta-analysis. Chest 2022;162:485-497.
DOI: https://doi.org/10.1016/j.chest.2022.02.027
Antonia SJ, Villegas A, Daniel D, et al. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med 2018;379:2342–50.
DOI: https://doi.org/10.1056/NEJMoa1809697
Robert C. A decade of immune-checkpoint inhibitors in cancer therapy. Nat Commun 2020;11:10–2.
DOI: https://doi.org/10.1038/s41467-020-17670-y
Bianco A, D’Agnano V, Matera MG, et al. Immune checkpoint inhibitors: a new landscape for extensive stage small cell lung cancer treatment. Expert Rev Respir Med 2021;15:1415–25.
DOI: https://doi.org/10.1080/17476348.2021.1964362
Reck M, Rodríguez-Abreu D, Robinson AG, et al. Pembrolizumab versus chemotherapy for PD-L1-positive non–small-cell lung cancer. N Engl J Med 2016;375:1823-33.
DOI: https://doi.org/10.1056/NEJMoa1606774
Spigel DR, Faivre-Finn C, Gray JE, et al. Five-year survival outcomes from the PACIFIC trial: Durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer. J Clin Oncol 2022;40:1301-11.
DOI: https://doi.org/10.1200/JCO.21.01308
Hass R, von der Ohe J, Ungefroren H. Impact of the tumor microenvironment on tumor heterogeneity and consequences for cancer cell plasticity and stemness. Cancers (Basel) 2020;12:3716.
DOI: https://doi.org/10.3390/cancers12123716
Yoon SM, Shaikh T, Hallman M. Therapeutic management options for stage III non-small cell lung cancer. World J Clin Oncol 2017;8:1-20.
DOI: https://doi.org/10.5306/wjco.v8.i1.1
Comella P, Frasci G, De Cataldis G, et al. Cisplatin/carboplatin + etoposide + vinorelbine in advanced non-small-cell lung cancer: A multicentre randomised trial. Br J Cancer 1996;74:1805-11.
DOI: https://doi.org/10.1038/bjc.1996.634
Bianco A, Malapelle U, Rocco D, et al.Targeting immune checkpoints in non small cell lung cancer. Curr Opin Pharmacol 2018;40:46-50.
DOI: https://doi.org/10.1016/j.coph.2018.02.006
Cattaneo F, Guerra G, Parisi M, Lucariello A, De Luca A, De Rosa N, et al. Expression of formyl-peptide receptors in human lung carcinoma. Anticancer Res 2015;35:2769–74.
Nigro E, Stiuso P, Matera MG, et al. The anti-proliferative effects of adiponectin on human lung adenocarcinoma A549 cells and oxidative stress involvement. Pulm Pharmacol Ther 2019;55:25-30.
DOI: https://doi.org/10.1016/j.pupt.2019.01.004
Patel SP, Kurzrock R. PD-L1 expression as a predictive biomarker in cancer immunotherapy. Mol Cancer Ther 2015;14:847–56.
DOI: https://doi.org/10.1158/1535-7163.MCT-14-0983
Incorvaia L, Fanale D, Badalamenti G, et al. Programmed death ligand 1 (PD-L1) as a predictive biomarker for pembrolizumab therapy in patients with advanced non-small-cell lung cancer (NSCLC). Adv Ther 2019;36:2600-17.
DOI: https://doi.org/10.1007/s12325-019-01057-7
Bianco A, Perrotta F, Barra G, et al. Prognostic factors and biomarkers of responses to immune checkpoint inhibitors in lung cancer. Int J Mol Sci 2019;20:2931.
DOI: https://doi.org/10.3390/ijms20194931
Aguilar EJ, Ricciuti B, Gainor JF, et al. Outcomes to first-line pembrolizumab in patients with non-small-cell lung cancer and very high PD-L1 expression. Ann Oncol 2019;30:1653-9.
DOI: https://doi.org/10.1093/annonc/mdz288
Sezer A, Kilickap S, Gümüş M, et al. Cemiplimab monotherapy for first-line treatment of advanced non-small-cell lung cancer with PD-L1 of at least 50%: a multicentre, open-label, global, phase 3, randomised, controlled trial. Lancet 2021;397:592-604.
DOI: https://doi.org/10.1016/S0140-6736(21)00228-2
Munari E, Zamboni G, Lunardi G, et al. PD-L1 expression comparison between primary and relapsed non-small cell lung carcinoma using whole sections and clone SP263. Oncotarget 2018;9:30465-71.
DOI: https://doi.org/10.18632/oncotarget.25770
Perrotta F, Rocco D, Vitiello F, et al. Immune checkpoint blockade for advanced NSCLC: A new landscape for elderly patients. Int J Mol Sci 2019;20:2258.
DOI: https://doi.org/10.3390/ijms20092258
Nosaki K, Saka H, Hosomi Y, et al. Safety and efficacy of pembrolizumab monotherapy in elderly patients with PD-L1–positive advanced non–small-cell lung cancer: Pooled analysis from the KEYNOTE-010, KEYNOTE-024, and KEYNOTE-042 studies. Lung Cancer 2019;135:188-95.
DOI: https://doi.org/10.1016/j.lungcan.2019.07.004
How to Cite
Medusa , Paola Maria, Marina Gilli, Luca Notizia, Raffaella Pagliaro, Nicola Carro, Alessandro Moriello, Vito D’Agnano, Andrea Bianco, Fabio Perrotta, and Fabiana Vitiello. 2022. “Complete Response to Pembrolizumab As a Single Agent in a Patient With Stage III NSCLC With High PD-L1 Expression: A Case Report”. Monaldi Archives for Chest Disease 93 (4). https://doi.org/10.4081/monaldi.2022.2440.
Copyright (c) 2022 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- N. Barbarito, E. De Mattia, Grading the severity of obstruction in patients with Chronic Obstructive Pulmonary Disease and morbid obesity , Monaldi Archives for Chest Disease: Vol. 79 No. 3-4 (2013): Pulmonary series
- M. Irfan, F. Thiavalappil, J. Nagaraj, T.H. Brown, D. Roberts, L. Mcknight, N.K. Harrison, Tuberculous pancreatitis complicated by ruptured splenic artery pseudoaneurysm , Monaldi Archives for Chest Disease: Vol. 79 No. 3-4 (2013): Pulmonary series
- Marzia Testa, Enrico Lombardo, Enrico Avogadri, Marco Agostini, Giuseppe Forte, Salvatore Piccolo, Mauro Feola, Infective endocarditis or myxoma? Description of a patient with new diagnosis of congestive heart failure , Monaldi Archives for Chest Disease: Vol. 78 No. 2 (2012): Cardiac series
- Cuneyt Tetikkurt, Buket Caliskaner Ozturk, Nejdiye Gungordu, Diagnosis of pleuroparenchymal fibroelastosis: A review , Monaldi Archives for Chest Disease: Vol. 93 No. 3 (2023)
- Ahmed Bakhit, Ajay Kumar Mishra, Khushal Choudhary, Mohamed Khaled Soufi, Aortic root fistula complicating Austrian syndrome , Monaldi Archives for Chest Disease: Vol. 91 No. 3 (2021)
- Vincenzo Russo, Anna Rago, Nunzia Laezza, Pierpaolo Di Micco, Laura Giannetti, Luigi Atripaldi, Antonio D'Onofrio, Paolo Golino, Gerardo Nigro, Edoxaban in elderly patient with morbid obesity and atrial fibrillation: the role of plasma levels evaluation for selecting the appropriate dose , Monaldi Archives for Chest Disease: Vol. 90 No. 1 (2020)
- Idir Ramdani, Karen A. Pescatore, Belaid Bouazza, Causes of hospitalization and characteristics of Algerian chronic obstructive pulmonary disease patients in Tizi-Ouzou: a retrospective study , Monaldi Archives for Chest Disease: Vol. 90 No. 3 (2020)
- Vito Maurizio Parato, Germana Gizzi, Simone D'Agostino, Simona Pelliccioni, Michele Scarano, An unusual case of severe left ventricle outflow tract obstruction due to a coexistence of Takotsubo cardiomyopathy with septal hypertrophic cardiomyopathy , Monaldi Archives for Chest Disease: Vol. 92 No. 3 (2022)
- Anna Jacob, Kranti Garg, Kashish Dutta, Varinder Saini, Deepak Aggarwal, Ajeet Sidana, Role of detailed psychological evaluation and treatment in pulmonary rehabilitation programs for patients with chronic obstructive pulmonary disease , Monaldi Archives for Chest Disease: Early Access
- Anshul Mittal, Pranav Ish, Vidushi Rathi, Satish Kumar Kumawat, Shibdas Chakrabarti, JC Suri, Rehabilitation in obstructive sleep apnea: an ignored treatment adjunct , Monaldi Archives for Chest Disease: Early Access
<< < 16 17 18 19 20 21 22 23 24 25 > >>
You may also start an advanced similarity search for this article.
