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Atypical response to anti‑PD‑1 therapy followed by long‑term survival in non‑small cell lung cancer – case reports
02/2020 MUDr. Gabriela Krákorová, Ph.D.; MUDr. Marek Šťastný, Ph.D.; MUDr. Hana Steinbergerová; MUDr. Jana Důrová; prof. MUDr. Miloš Pešek, CSc.; doc. MUDr. Jan Baxa, Ph.D.
Metastatic non-small cell lung cancer has poor prognosis. In the absence of driving mutations (EGFR, ALK, ROS, BRAF) or high expression of programmed death-ligand 1 (PD-L1), chemotherapy or its combination with bevacizumab is the initial treatment option with respect to reimbursement conditions in the Czech Republic. The second line possibility is the use of immunotherapy with inhibitors of protein 1 of programmed cell death (anti-programmed death-1, anti-PD-1) or inhibitors its ligand, anti-PD-LI. The authors present two case reports of patients, who had an atypical response following immunotherapy. This was the persistent effect of immunotherapy, despite the progression on this treatment. The first patient had no need for another active oncology treatment for further 12 months after immunotherapy and the malignancy had not been significantly progressing. The second patient developed a significant response to chemotherapy following anti-PD-1 immunotherapy. This phenomenon, in the literature referred not quite correctly to as chemosensitization, is repetitively described. Next the authors also consider the possibilities of treatment of the next line after immunotherapy failure.
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Metastatic non-small cell lung cancer has poor prognosis. In the absence of driving mutations (EGFR, ALK, ROS, BRAF) or high expression of programmed death-ligand 1 (PD-L1), chemotherapy or its combination with bevacizumab is the initial treatment option with respect to reimbursement conditions in the Czech Republic. The second line possibility is the use of immunotherapy with inhibitors of protein 1 of programmed cell death (anti-programmed death-1, anti-PD-1) or inhibitors its ligand, anti-PD-LI. The authors present two case reports of patients, who had an atypical response following immunotherapy. This was the persistent effect of immunotherapy, despite the progression on this treatment. The first patient had no need for another active oncology treatment for further 12 months after immunotherapy and the malignancy had not been significantly progressing. The second patient developed a significant response to chemotherapy following anti-PD-1 immunotherapy. This phenomenon, in the literature referred not quite correctly to as chemosensitization, is repetitively described. Next the authors also consider the possibilities of treatment of the next line after immunotherapy failure.