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Review
. 2020 Mar;8(5):245.
doi: 10.21037/atm.2020.01.118.

Perioperative chemoimmunotherapy in a patient with stage IIIB non-small cell lung cancer

Hengrui Liang  1 , Hongsheng Deng  1 , Wenhua Liang  1 , Kai Guo  2 , Ziqing Gao  2 , Ory Wiesel  3 , Raja M Flores  4 , Kimberly Song  4 , Bassam Redwan  5 , Marcello Migliore  6 , Shuben Li  1 , Weiqiang Yin  1 , Jianxing He  1
Affiliations
Review

Perioperative chemoimmunotherapy in a patient with stage IIIB non-small cell lung cancer

Hengrui Liang et al. Ann Transl Med. 2020 Mar.

Abstract

We present a case of a 56-year-old male patient with stage IIIB (T3N2M0) poorly differentiated squamous cell carcinoma of the lung. Four cycles of chemotherapy were first applied, and the patient had stable disease. However, the patient refused to receive radiotherapy, therefore second-line treatment chemotherapy combined with anti-PD-1 immunotherapy was applied. Partial response was reached at the 4th cycle of chemotherapy combined with anti-PD-1 immunotherapy. The neoadjuvant strategy was prolonged to 10 cycles but no significant change was observed on tumor size. The patient then underwent video-assisted thoracoscopic left lower lobectomy. Eight cycles of adjuvant PD-1 immunotherapy were applied postoperatively. Perioperative immunotherapy demonstrated good curative effect in this patient and no recurrence was observed at the clinic 40 months following surgery. Here we intend to explore the concept of immunotherapy combined with chemotherapy and surgery in neoadjuvant and adjuvant setting, and to investigate the possibility of extending this strategy in patients with stage IIIB non-small cell lung cancer (NSCLC).

Keywords: Non-small cell lung cancer (NSCLC); perioperative PD-1 inhibitor; stage IIIB.

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Conflict of interest statement

Conflicts of Interest: OW serves as an unpaid editorial board member of Annals of Translational Medicine from Oct 2019 to Sep 2021. RMF serves as an unpaid editorial board member of Annals of Translational Medicine from Jan 2020 to Dec 2021. BR serves as an unpaid editorial board member of Annals of Translational Medicine from Oct 2019 to Sep 2021. MM serves as an unpaid editorial board member of Annals of Translational Medicine from Dec 2018 - Nov 2020. JH serves as an unpaid Editor-in-Chief of Annals of Translational Medicine from Jun 2019 to May 2024. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PET-CT examination proving multiple lung cancers occurred in the posterolateral basal segment of the left lower lobe (4.5 cm × 3.7 cm; SUV 10.9) and the root of the left pulmonary hilum (4.0 cm × 2.9 cm; SUV 10.4) (Baseline) (2014-09-17).
Figure 2
Figure 2
An overview of tumor markers (CEA/CA125/CA133) concentration in this case during the therapeutic process.
Figure 3
Figure 3
PET-CT examination after 4 cycles of chemotherapy demonstrating reduction of lesions (2015-01-27).
Figure 4
Figure 4
CT scan after 4 cycles of PD-1 immunotherapy demonstrating the therapeutical effect as PR (2015-06-01). PR, pathological response.
Figure 5
Figure 5
CT scan after 10 cycles of PD-1 immunotherapy demonstrating no significant change compared to that after 4 cycles of PD-1 immunotherapy (2015-11-23).
Figure 6
Figure 6
Treatment flow chart of the patient from September 2014 to April 2019.
See this image and copyright information in PMC

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