Skip to main content

Advertisement

Log in

Concurrent combination of irradiation and immune checkpoint inhibitor for recurrent pleomorphic carcinoma of the lung

  • Case report
  • Published:
International Cancer Conference Journal Aims and scope Submit manuscript

Abstract

We report the case of a 49-year-old patient who developed brain, sternal, and spine metastases almost simultaneously after the radical resection of a yp-T4N0M0 pulmonary pleomorphic carcinoma of the right upper lobe following induction chemotherapy. The left occipital brain metastasis was surgically removed and followed by radiation therapy. The sternal and vertebral metastases were treated with radiation therapy. Concurrently, the immune checkpoint inhibitor nivolumab was administered. After 12 cycles of nivolumab, the two bone metastases were well-controlled. However, the brain metastasis recurred and was surgically removed again. We were able to investigate the tumor-infiltrating lymphocytes in brain metastases resected before and after radio-immunotherapy. The results revealed the increased number of CD8- and CD68-positive cells after the combined therapy compared with before the therapy. In addition, the high-level expression of program death-ligand 1 was maintained in the brain metastasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Postow MA, Callahan MK, Barker CA, Yamada Y, Yuan J, Kitano S et al (2012) Immunologic correlates of the abscopal effect in a patient with melanoma. N Engl J Med 366:925–931

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Kim S, Kim MY, Koh J, Go H, Lee DS, Jeon YK, Chung DH (2015) Programmed death-1 ligand 1 and 2 are highly expressed in pleomorphic carcinomas of the lung: comparison of sarcomatous and carcinomatous area. Eur J Cancer 51:2698–2707

    Article  CAS  PubMed  Google Scholar 

  3. Ito K, Hataji O, Katsuta K, Kobayashi T, Gabazza E, Yatabe Y et al (2016) “Pseudoprogression” of pulmonary pleomorphic carcinoma during nivolumab therapy. J Thorac Oncol 11:e117–e119

    Article  PubMed  Google Scholar 

  4. Shaverdian N, Lisberg AE, Bornazyan K, Veruttipong D, Goldman JW, Formenti SC et al (2017) Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial. Lancet Oncol 18:895–903

    Article  CAS  PubMed  Google Scholar 

  5. Levy A, Massard C, Sonia JC, Deutsch E (2016) Concurrent irradiation with the anti-programmed cell death ligand-1 immune checkpoint blocker durvalumab: single centre subset analysis from a phase 1/2 trial. Eur J Cancer 68:156–162

    Article  CAS  PubMed  Google Scholar 

  6. Goldberg SB, Gettinger SN, Mahajan A, Chiang AC, Herbst RS, Sznol M et al (2016) Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial. Lancet Oncol 17:976–983

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R et al (2017) Durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer. N Engl J Med. https://doi.org/10.1056/NEJMoa1709937

    PubMed  Google Scholar 

  8. Lakin N, Rulach R, Nowicki S, Kurian KM (2017) Current advances in checkpoint inhibitor: lessons from non-central nervous system cancers and potential for glioblastoma. Front Oncol 7:141. https://doi.org/10.3389/fonc.2017.00141

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ken Kodama.

Ethics declarations

Ethical statement

This report was approved by ethics committee of our hospital (No. 110617-13).

Conflict of interest

All authors have declared no conflicts of interest.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kodama, K., Maniwa, T., Kimura, Y. et al. Concurrent combination of irradiation and immune checkpoint inhibitor for recurrent pleomorphic carcinoma of the lung. Int Canc Conf J 7, 43–47 (2018). https://doi.org/10.1007/s13691-017-0315-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13691-017-0315-9

Keywords

Navigation