Long-Term Response in PD-L1-Negative Advanced Non-Small Cell Lung Carcinoma With Discontinued and Restarted Nivolumab Therapy Due to Immune-Related Adverse Event
- VernacularTitle:免疫関連有害事象のためニボルマブ休薬後，再投与にて重篤な有害事象の再発なく長期奏効を得たPD-L1陰性進行非小細胞肺癌の1例
- Author:
Tomoshige CHIAKI
1
;
Soichi MARUYAMA
1
;
Shinya FUJII
1
Author Information
- From:Journal of the Japanese Association of Rural Medicine 2020;68(6):797-
- CountryJapan
- Language:Japanese
- Abstract: The patient was 67-year-old woman with non-small cell lung carcinoma (squamous cell carcinoma, T2bN2M1a, Stage IVA) who was started on fifth-line therapy with nivolumab, an immune checkpoint inhibitor. Although tumor biopsy was negative for programmed cell death ligand 1 (PD-L1), the tumor size decreased. Nivolumab had to be discontinued due to suspected immune-related adverse events (i.e., skin rash and enteritis symptoms), but the tumor size reduction persisted after discontinuation and complete response was maintained for ≥ 8 months. After disease recurrence, nivolumab therapy was restarted. The tumor size decreased, and partial response was achieved and maintained. The disease was successfully controlled for ≥ 2 years (27 courses of nivolumab), when nivolumab therapy was again discontinued due to skin rash. Despite the PD-L1-negative status, the patient achieved long-term response to nivolumab therapy. The immune-related adverse events in this case were comparable between the initial and reintroduced nivolumab therapy, suggesting that nivolumab is safe to administer over the long term.
