Li D, Cheng C, Song WP, Ni PZ, Zhang WZ, Wu X. Dramatic response to immunotherapy in an epidermal growth factor receptor-mutant non-small cell lung cancer: A case report. World J Clin Cases 2021; 9(36): 11419-11424 [PMID: 35071573 DOI: 10.12998/wjcc.v9.i36.11419]
Corresponding Author of This Article
Xuan Wu, MD, Doctor, Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, No. 127 Dongming Road, Zhengzhou 450008, Henan Province, China. 843240113@qq.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ding Li, Wen-Ping Song, Wen-Zhou Zhang, Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, Henan Province, China
Ding Li, Wen-Ping Song, Wen-Zhou Zhang, Henan Engineering Research Center for Tumor Precision Medicine and Comprehensive Evaluation, Zhengzhou 450008, Henan Province, China
Cheng Cheng, Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, Henan Province, China
Pei-Zan Ni, Department of Radiotherapy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, Henan Province, China
Xuan Wu, Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, Henan Province, China
Author contributions: Li D and Cheng C gave medical assistance to the study population and collected the data; Song WP, Wu X and Ni PZ analyzed the data; Li D wrote the draft of the manuscript; Zhang WZ and Wu X reviewed all versions of the manuscript and helped to shape it up; all authors contributed to the article and approved the submitted version.
Supported byHenan Provincial Science and Technology Research Project, No. 202102310157; Medical Science and Technology Research Plan (Joint Construction) Project of Henan Province, No. LHGJ20190676.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xuan Wu, MD, Doctor, Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, No. 127 Dongming Road, Zhengzhou 450008, Henan Province, China. 843240113@qq.com
Received: July 4, 2021 Peer-review started: July 4, 2021 First decision: September 28, 2021 Revised: September 29, 2021 Accepted: November 18, 2021 Article in press: November 18, 2021 Published online: December 26, 2021 Processing time: 172 Days and 5.2 Hours
Abstract
BACKGROUND
The advent of immune checkpoint inhibitors (ICIs) has revolutionized the management of several types of solid cancers, including lung cancer, by boosting the body's natural tumor killing response. However, it is undeniable that only a small proportion of non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations can achieve long-term responses and benefit from immunotherapy.
CASE SUMMARY
Herein, we report the case of a 48-year-old man diagnosed with stage IV lung adenocarcinoma with an EGFR L858R mutation who was administered pembrolizumab monotherapy followed by pemetrexed and achieved a 10-month progression-free survival interval. In this case report, we show that ICIs were effective for our patient with EGFR-mutated NSCLC and discuss the characteristics of patients who can benefit from immunotherapy.
CONCLUSION
We suggest that patients with EGFR-mutated NSCLC with high PD-L1 expression (defined as ≥ 25%), the L858R mutation, smoking history, or pemetrexed pretreatment may benefit from immunotherapy.
Core Tip: In this paper, we report a patient with metastatic epidermal growth factor receptor-mutant non-small cell lung cancer showed dramatic response to immunotherapy after pemetrexed plus carboplatin and achieved a durable disease control over 10 mo. We aimed to analyze the potential reasons why the patient can benefit from immunotherapy and explore the strategy that should be adopted in the future.
