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
- Charalampos Chrysanthos Mylonas, Georgia Gomatou, Garyphallia Poulakou, Eleni Moraitou, Konstantinos Syrigos, Human disease caused by Streptococcus alactolyticus: a case report of native valve infective endocarditis and review of the literature , Monaldi Archives for Chest Disease: Vol. 90 No. 4 (2020)
- Michele Vitacca, Marta Lazzeri, Enrico Guffanti, Pamela Frigerio, Francesco D’Abrosca, Silvia Gianola, Mauro Carone, Mara Paneroni, Piero Ceriana, Franco Pasqua, Paolo Banfi, Francesco Gigliotti, Carla Simonelli, Serena Cirio, Veronica Rossi, Chiara G. Beccaluva, Mariangela Retucci, Martina Santambrogio, Andrea Lanza, Francesca Gallo, Alessia Fumagalli, Marco Mantero, Greta Castellini, Mariaconsiglia Calabrese, Giorgio Castellana, Eleonora Volpato, Marina Ciriello, Marina Garofano, Enrico Clini, Nicolino Ambrosino, on behalf of AIPO, ARIR, SIP, AIFI and SIFIR, An Italian consensus on pulmonary rehabilitation in COVID-19 patients recovering from acute respiratory failure: results of a Delphi process , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
- Abdula Elawady, Ahmed Khalil, Omar Assaf, Samirah Toure, Christopher Cassidy, Telemedicine during COVID-19: a survey of Health Care Professionals’ perceptions , Monaldi Archives for Chest Disease: Vol. 90 No. 4 (2020)
- Hassan H. Allam, Abdulhalim J. kinsara, Amtalkhaliq Alrajawi , Tareq Tuaima, Olga Vriz, Transverse sinus mass misinterpreted as the source of cardiac emboli , Monaldi Archives for Chest Disease: Vol. 91 No. 1 (2021)
- Mohammad Abu-Hishmeh, Laura Miranda, Fouzia Shakil, Tauseef Ahmed, Oleg Epelbaum, Hammering home the sickle: an instructive case of endobronchial anaplastic large cell lymphoma , Monaldi Archives for Chest Disease: Vol. 91 No. 3 (2021)
- Rafael Martínez-Girón, Liron Pantanowitz, Pulmonary actinomycosis: cytomorphological features , Monaldi Archives for Chest Disease: Vol. 92 No. 2 (2022)
- Konstantinos Kapriniotis, Angelina Bania, Savvas Lampridis, Georgios Geropoulos, Sofoklis Mitsos, Fleur Monk, David A. Moore, Nikolaos Panagiotopoulos, Metastatic mandibular ameloblastoma of the lung ten years after primary resection: A rare case report , Monaldi Archives for Chest Disease: Vol. 91 No. 2 (2021)
- Vera Auchynka, Ajay M.V. Kumar, Hennadz Hurevich, Yuliia Sereda, Varvara Solodovnikova, Dzmitry Katovich, Svetlana Setkina, Askar Yedilbayev, Aliaksandr Skrahin, Alena Skrahina, Effectiveness and cardiovascular safety of delamanid-containing regimens in adults with multidrug-resistant or extensively drug-resistant tuberculosis: A nationwide cohort study from Belarus, 2016-18 , Monaldi Archives for Chest Disease: Vol. 91 No. 1 (2021)
- Mariana Buziashvili, Hayk Davtyan, Yuliia Sereda, Olga Denisiuk, Ogtay Gozalov, Nino Lomtadze, Arax Hovhannesyan, Incidence rate and time to serious adverse events among rifampicin resistant tuberculosis patients in Georgia treated with new and repurposed anti-tuberculosis drugs, 2016-2018 , Monaldi Archives for Chest Disease: Vol. 91 No. 1 (2021)
- Valeriu Plesca, Ana Ciobanu, Yuliia Sereda, Andrei Dadu, Do catastrophic costs impact treatment outcomes in people with rifampicin-resistant tuberculosis in the Republic of Moldova? , Monaldi Archives for Chest Disease: Vol. 91 No. 1 (2021)
<< < 38 39 40 41 42 43 44 45 46 47 > >>
You may also start an advanced similarity search for this article.
