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Case Reports
. 2018 Mar 20;18(1):302.
doi: 10.1186/s12885-018-4212-1.

Re-challenging immune checkpoint inhibitor in a patient with advanced non-small cell lung cancer: a case report

Taiki Hakozaki  1 , Yusuke Okuma  2 , Jumpei Kashima  3
Affiliations
Case Reports

Re-challenging immune checkpoint inhibitor in a patient with advanced non-small cell lung cancer: a case report

Taiki Hakozaki et al. BMC Cancer. .

Abstract

Background: Currently, immune checkpoint (ICP) inhibitors are essential drugs for the treatment of non-small cell lung cancer (NSCLC). However, in patients previously treated with ICP inhibitors, the efficacy and safety of re-challenging the same or another ICP inhibitor remain unclear.

Case presentation: We present the case of a patient treated with nivolumab for advanced NSCLC who was previously treated with an ICP inhibitor as the first-line chemotherapy along with heavy cytotoxic chemotherapy. After the failure of five lines of chemotherapy, 3 cycles of nivolumab, as the ICP inhibitor re-challenge, the patient achieved a partial response.

Conclusions: This case might suggest that re-challenging an ICP inhibitor could be clinically active in selected patients with advanced NSCLC who progress after achieving an initial clinical benefit with an ICP inhibitor.

Keywords: Immune checkpoint inhibitor; Immune-related adverse events; Nivolumab; Non-small cell lung cancer; Re-challenge.

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Conflict of interest statement

Ethics approval and consent to participate

The case report was waivered by the Ethics Committee of Tokyo Metropolitan Cancer and Infectious disease Center Komagome Hospital. The clinical information presented in this case report was obtained through Tokyo Metropolitan Cancer and Infectious disease Center Komagome Hospital’s medical records.

Consent for publication

Written informed consent was obtained from the patients for publication of this case report.

Competing interests

All authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Radiographic results before and after ICP inhibitors. The CT scan shows the primary lesion in the right upper lobe before the first-line ICP inhibitor (a), SD after 2 months accompanied by alveolitis (c, d), and enlarged after 4 months (b). After the failure of five lines of chemotherapy (e), the primary lesion responded to 3 cycles of nivolumab (f)
Fig. 2
Fig. 2
Lung biopsy demonstrated mild fibrinolytic hyperplasia of alveolar septum and strong infiltration of lymphocytes, including small fraction of eosinophil. Alveolar cells were swollen and form cells were accumulated ((a): X100, (b, c): X200)
See this image and copyright information in PMC

References

    1. Brahmer J, Reckamp KL, Baas P, Crino L, Eberhardt WE, Poddubskaya E, Antonia S, Pluzanski A, Vokes EE, Holgado E, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung Cancer. N Engl J Med. 2015;373(2):123–135. doi: 10.1056/NEJMoa1504627. - DOI - PMC - PubMed
    1. Borghaei H, Paz-Ares L, Horn L, Spigel DR, Steins M, Ready NE, Chow LQ, Vokes EE, Felip E, Holgado E, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung Cancer. N Engl J Med. 2015;373(17):1627–1639. doi: 10.1056/NEJMoa1507643. - DOI - PMC - PubMed
    1. Herbst RS, Baas P, Kim DW, Felip E, Perez-Gracia JL, Han JY, Molina J, Kim JH, Arvis CD, Ahn MJ, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet. 2016;387(10027):1540–1550. doi: 10.1016/S0140-6736(15)01281-7. - DOI - PubMed
    1. Rittmeyer A, Barlesi F, Waterkamp D, Park K, Ciardiello F, von Pawel J, Gadgeel SM, Hida T, Kowalski DM, Dols MC, et al. Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial. Lancet. 2017;389(10066):255–265. doi: 10.1016/S0140-6736(16)32517-X. - DOI - PMC - PubMed
    1. Reck M, Rodriguez-Abreu D, Robinson AG, Hui R, Csoszi T, Fulop A, Gottfried M, Peled N, Tafreshi A, Cuffe S, et al. Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung Cancer. N Engl J Med. 2016;375(19):1823–1833. doi: 10.1056/NEJMoa1606774. - DOI - PubMed

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