Complete response of squamous cell carcinoma of the lung following treatment with pembrolizumab in an elderly patient: A case report

Abstract

Complete response of non-small cell lung cancer (NSCLC) with immune checkpoint inhibitor (ICI) monotherapy is rare. Here, we encountered an elderly patient who showed complete response of NSCLC following treatment with pembrolizumab. An 84-year-old man with a history of bloody sputum for several weeks visited a general physician. At that time, a chest X-ray revealed a tumor shadow in the left middle lung field, and the patient was referred to our hospital. Following transbronchial biopsy, he was diagnosed with squamous cell carcinoma of the lung. Expression of programmed death ligand 1 (PD-L1) in tumor cells was 80% or more by immunostaining. Based on the above, immunotherapy with pembrolizumab was performed as first-line therapy. The cancer cells completely disappeared at the end of the fifth cycle. There were no side effects during the therapeutic course. Treatment with pembrolizumab continued for two years and was then discontinued at the patient's request. Since then, no tumor recurrence has been detected for about one and a half years without treatment. There have been few reports of lung cancer disappearing after treatment with pembrolizumab. In conclusion, in elderly NSCLC patients with PD-L1 expression of 50% or more, pembrolizumab should be considered as first-line treatment with the treatment period, and mechanism suggested in this report.

Successful treatment of two patients with unresectable lung squamous cell carcinoma with tislelizumab regardless of programmed death-ligand 1 expression: a report of two cases

“…According to the present reported cases, patients with lung cancer for tislelizumab were extremely rare [ 6 , 12 ], and we did not find any case report with a significant response or even complete response in SCC treated with tislelizumab. Similarly, a few cases show the effectiveness of pembrolizumab for lung SCC [ 13 – 15 ].…”

Dramatic, significant metabolic response to a one‐time pembrolizumab treatment following a relapse of pre‐existing organizing pneumonia in a patient with advanced non‐small cell lung cancer: A case report

“…The frequency of complete response is significantly higher in patients who receive either ICI treatment or ICIs in addition to cytotoxic chemotherapy agents than in patients who receive cytotoxic chemotherapy alone 7 . Additionally, many reports have shown a complete response to ICI treatment in patients with NSCLC 8 . These cases were administered ICI treatment multiple times until a complete response was achieved.…”

“… 7 Additionally, many reports have shown a complete response to ICI treatment in patients with NSCLC. 8 These cases were administered ICI treatment multiple times until a complete response was achieved. On the other hand, our patient showed a significant metabolic response despite only a single ICI treatment.…”

The Right Dose: From Phase I to Clinical Practice

“…Although a similar analysis has not been performed (to our knowledge) for patent-protected parenteral drugs, there are some important opportunities, best exemplified by the immune checkpoint inhibitors. [49][50][51][52][53][54] Furthermore, because many patients treated with immune checkpoint inhibitors have prolonged progression-free survival (PFS) despite treatment discontinuation (e.g., due to adverse events), [55][56][57][58][59][60] the optimal duration of treatment is unknown. [61][62][63] Strategy to Identify Candidate Drugs for Financially Guided Dosing…”