Intracranial Response to Nivolumab in a Patient with PD-L1-negative Lung Adenocarcinoma.

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Intracranial Response to Nivolumab in a Patient with PD-L1-negative Lung Adenocarcinoma.

Intern Med. 2018 Nov 01;57(21):3149-3152

Authors: Nakahara Y, Fukui T, Shirasawa M, Harada S, Kusuhara S, Takakura A, Yokoba M, Mitsufuji H, Kubota M, Katagiri M, Sasaki J, Masuda N, Inukai M, Sekiguchi T, Naoki K

Abstract
We herein report the case of a 52-year-old man with stage IV lung adenocarcinoma. The patient was negative for epidermal growth factor receptor (EGFR) mutations and echinoderm microtubule-associated protein-like 4 (EML4) /anaplastic lymphoma kinase (ALK) rearrangement. He was treated with nivolumab as a third-line chemotherapy. After four cycles of nivolumab treatment, a partial response was observed in the brain and at the primary tumor site. Nivolumab treatment has been continued for 11 months without progression. Immunohistochemistry revealed that the programmed death-ligand 1 (PD-L1) expression was 0% (according to the tumor proportion score). Our case indicates that the efficacy of programmed cell death 1 inhibitors is not solely predicted by the PD-L1 status, and that immune checkpoint inhibitors might be effective for the treatment of central nervous system metastasis.

PMID: 29877291 [PubMed - indexed for MEDLINE]

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