The changing face of cancer treatments

Abstract

This case demonstrates the effectiveness and ongoing potential of novel lung cancer therapies, specifically immunotherapy agents such as nivolumab, a T-cell programmed death 1 (PD-1) receptor inhibitor. In this case study, our patient had a significant burden of disease with nodal involvement above and below the diaphragm at the time of diagnosis. They were commenced on standard of care therapy: cisplatin and pemetrexed. Despite five cycles of treatment with these agents, their disease progressed significantly with the development of brain metastasis. The patient was switched to a novel immunotherapy agent, nivolumab, and had a complete response to it. Currently, there is no active disease-the lymph nodes have all regressed, the brain metastases have disappeared (with the help of stereotactic surgery) and no further metastases have developed. The patient is tolerating the treatment well and has had no significant adverse reactions to the immunotherapy agent.

Keywords: lung cancer (oncology); oncology.

Figure 1

CT pulmonary angiogram at presentation showing pleural effusion and lung cancer.

Figure 2

CT abdomen/pelvis showing abdominal lymphadenopathy.

Figure 3

(A)MRI brain showing metastasis from lung cancer.(B): MRI brain showing metastasis from lung cancer.

Figure 4

Post-treatment CT pulmonary angiogram showing complete resolution of lung disease.

Figure 5

Post-treatment CT abdomen/pelvis showing major regression of lymphadenopathy.