Case Report: PD-1 Inhibitor Is Active in Lung Adenocarcinoma With B Cell Deficiency.
Front Immunol
; 11: 563622, 2020.
Article
em En
| MEDLINE
| ID: mdl-33240259
ABSTRACT
Introduction:
In murine cancer models, B cells are unnecessary for efficacy of PD-1 inhibitor. However, we do not know whether this applies to clinical settings, especially in patients with non-small-cell lung carcinoma (NSCLC). Case presentation We report on the case of an advanced lung adenocarcinoma patient without oncogenic driver mutations whose disease progressed on second-line bevacizumab-containing chemotherapy regimens. These previous treatments resulted in profound thrombocytopenia and increased number of B cells; both effects were hard to alleviate. The patient was diagnosed with marginal zone B-cell lymphoma by flow cytometry immunophenotyping. After five cycles of rituximab in combination with lenalidomide treatment, the percentage of B cells rapidly declined to undetectable levels and the lymphoma regressed completely. However, because masses in the lung gradually increased, this patient was subsequently treated with a PD-1 inhibitor. The patient's condition stabilized, and the mass shrank to reach partial response, with progression free survival exceeding 15 months and no serious adverse events.Conclusion:
The present case proves the efficacy of PD-1 inhibitor in metastatic lung adenocarcinoma in the absence of B cells. Immune checkpoint inhibitions are thus a choice for patients with B cell deficiencies, such as X-linked agammaglobulinemia, immunoglobulin deficiencies, and common variable immunodeficiency, diseases that have historically been excluded from clinical trials for oncologic drugs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Linfócitos B
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Carcinoma Pulmonar de Células não Pequenas
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Linfoma de Zona Marginal Tipo Células B
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Anticorpos Monoclonais Humanizados
/
Receptor de Morte Celular Programada 1
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Adenocarcinoma de Pulmão
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Inibidores de Checkpoint Imunológico
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Neoplasias Pulmonares
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Front Immunol
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
China