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: 1184
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
- L. Ceron, L. Michieletto, A. Zamperlin, Mediastinal staging in lung cancer: a rational approach , Monaldi Archives for Chest Disease: Vol. 71 No. 4 (2009): Pulmonary series
- L. Fuso, G. Pagliari, V. Boniello, A. Trovè, F. Varone, A. Longobardi, S. Basso, L. Trodella, Autofluorescence bronchoscopy to identify pre-cancerous bronchial lesions , Monaldi Archives for Chest Disease: Vol. 63 No. 3 (2005): Pulmonary series
- Seyed Kianoosh Hosseini, Abbas Soleimani, Abbas Ali Karimi, Saeed Sadeghian, Sirous Darabian, Seyed Hesameddin Abbasi, Seyed Hossein Ahmadi, Arezou Zoroufian, Mehran Mahmoodian, Ali Abbasi, Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMI) in young adults under 40 years of age , Monaldi Archives for Chest Disease: Vol. 72 No. 2 (2009): Cardiac series
- Emanuele Stirpe, Floriana Bardaro, Johanna Köhl, Unusual lymphadenopathy diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Cristiano Cesaro, Umberto Caterino, Fabio Perrotta, Umberto Masi, Alessandra Cotroneo, Roberta Cianci, Enzo Zamparelli, Flavio Cesaro, Dario Amore, Danilo Rocco, Alectinib rescue therapy in advanced ALK rearranged lung adenocarcinoma: a case report , Monaldi Archives for Chest Disease: Vol. 93 No. 3 (2023)
- Kevin John, Ajay Kumar Mishra, Jemimah Nayar, Jordy Mehawej, Amos Lal, Coronavirus disease 2019 and mechanical circulatory support devices: a comprehensive review , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Vinay V, Sushil Kumar Munjal, Sandeep Jain, Yasir Abdullah V, Arunachalam M, Srinath Shankar Iyer, To investigate the knowledge, attitude and practices regarding tuberculosis case notification among public and private doctors practicing of modern medicine in South Delhi , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Vasileios Gkogkos, Georgia-Emmanouela Dendrinou, Ioanna Papadaki, Maria Christodoulou, Charalampos Stoumpos, Timothy Sakellaridis, Kyriaki Zeibecoglou, Dimitrios Papadopoulos, Musculoskeletal tuberculosis with multifocal muscle abscesses in a healthy young adult , Monaldi Archives for Chest Disease: Vol. 93 No. 3 (2023)
- Ravi Manglani, Sara Akbar, Mary Beth Beasley, Oleg Epelbaum, A 44-year-old stone worker with progressive dyspnea: lessons from a new twist on an old foe , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Jury Brandolini, Francesca Ambrosi, Pietro Bertoglio, Barbara Bonfanti, Sergio Nicola Forti Parri, Elena Garelli, Kenji Kawamukai, Piergiorgio Solli, Robotic resection of mediastinal left vagus neurofibroma , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
<< < 32 33 34 35 36 37 38 39 40 41 > >>
You may also start an advanced similarity search for this article.
