A case report of sustained clinical remission in patients with locally advanced lung adenocarcinoma after sequential immunotherapy following concurrent chemoradiotherapy

Abstract

Lung cancer is the most common cause of cancer-related deaths worldwide. Pathologically, lung cancer can be non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC), while NSCLC accounts for approximately 85% of lung cancer patients. Stage III NSCLC represents a heterogeneous group of disease entities that are potentially curable and are usually dealt with multimodality treatments involving radiotherapy, chemotherapy, and surgical resection. Immune checkpoint inhibitors (ICIs) target programmed cell death receptor-1 (PD-1) and programmed death-ligand 1 (PD-L1). Studies have shown that ICIs have excellent and long-lasting anti-cancer effects in many cancers. The PACIFIC study is the first in the systemic treatment of stage III unresectable NSCLC in the past few decades that both progression-free survival (PFS) and overall survival (OS) have obtained positive results, However, the performance of this treatment strategy remains to be studied in a real-world setting. Such as who will benefit from treatment is still worthy of our continuous exp loration. In this paper, a patient with locally advanced unresectable NSCLC who underwent concurrent chemoradiotherapy followed by sequential immunotherapy (durvalumab) was reported. The patient obtained sustained clinical benefits despite low PD-L1 expression. This case report may serve as a reference for clinicians to make diagnostic and treatment decisions in clinical practice.