Prolonged disease control with nivolumab in metastatic lung adenocarcinoma during immunotherapy era

Abstract

Immune checkpoint inhibitors have taken an important place in the field of oncologic immunotherapy, especially for patients in whom conventional treatment regimens have failed. Nivolumab prevents programmed cell death 1 (PD-1) and programmed cell death ligand-1 (PD-L1) binding, resulting in blockage of the inhibitory signal and thus facilitating an immunologic antitumor response. Nivolumab has been shown to be effective in thoracic malignancies, including non-small cell lung cancer (NSCLC). Here is a case of 52-year male patient with metastatic lung adenocarcinoma progressing after 4 cycles of chemotherapy. We started nivolumab q2 weeks therapy. Firstly, his dyspnea relieved, carcinoembryonic antigen (CEA) and C-reactive protein (CRP) levels regressed, and then their levels remained constant at a stable level. Radiologically stable response was seen. Progression was seen after about one and half year. Patient died in a short time after progression. In conclusion, this observation provides a strong indication of the potential value of immune checkpoint inhibitors for the management of metastatic lung cancers.