Dramatic response to immunotherapy in an epidermal growth factor receptor-mutant non-small cell lung cancer: A case report

Abstract

BACKGROUND The advent of immune checkpoint inhibitors (ICIs) has revolutionized the management of several types of solid cancers, including lung cancer, by boosting the body's natural tumor killing response. However, it is undeniable that only a small proportion of non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations can achieve long-term responses and benefit from immunotherapy. CASE SUMMARY Herein, we report the case of a 48-year-old man diagnosed with stage IV lung adenocarcinoma with an EGFR L858R mutation who was administered pembrolizumab monotherapy followed by pemetrexed and achieved a 10-month progression-free survival interval. In this case report, we show that ICIs were effective for our patient with EGFR-mutated NSCLC and discuss the characteristics of patients who can benefit from immunotherapy. CONCLUSION We suggest that patients with EGFR-mutated NSCLC with high PD-L1 expression (defined as ≥ 25%), the L858R mutation, smoking history, or pemetrexed pretreatment may benefit from immunotherapy.

Prognostic value and immune regulatory role of dynamin 1-like in lung adenocarcinoma

“…However, resistance to ICIs is a common phenomenon, leading to disease progression following an initial response to treatment ( 5 , 6 ). A greater understanding of the biological mechanisms underlying the resistance to ICIs may contribute to the development of more effective immunotherapies ( 7 ). One possible mechanism that plays in the development of resistance to ICIs is the inhibition of migration and infiltration of T cells to the immune tumor microenvironment (TME), which results in a functionally exhausted phenotype ( 8 ).…”