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Hua min Shi
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P2.07 - Immunology and Immunotherapy (ID 708)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.07-043 - Efficacy and Safety of Anti-PD-1 Antibody as the First Line Treatment in Elderly Patient with Advanced Lung Squamous Cell Carcinoma: A Case Report (ID 9952)
09:30 - 09:30 | Presenting Author(s): Hua min Shi
- Abstract
Background:
To evaluate the efficacy and safety of PD-1 antibody in first-line treatment of advanced lung squamous cell carcinoma
Method:
To analyze the short-term efficacy and related adverse effects of PD-1 antibody in one elderly patient with advanced squamous cell carcinoma of the lung.
Result:
An eighty-year-old male was hospitalized due to "cough with blood-stained sputum for two months", who was physically healthy in the past years and had a long-term history of smoking. Two months ago, he began to cough with blood-stained sputum occasionally. He had no chest pain, dyspnea, fever and night sweat. He went to local hospital for diagnosis and chest CT showed right upper lobe mass and atelectasis. The up-mentioned symptoms got worse one month ago and percutaneous aspiration lung biopsy was performed in local hospital. The pathological study showed squamous cell carcinoma of lung and the result of EGFR mutation testing was wild type. After transferring to our hospital, bronchoscopy revealed lumen in upper right was completely obstructed by neoplasm and trachea and right middle bronchus presented with compressive stricture. Biopsy was performed and immunohistochemistry study confirmed the diagnosis of lung squamous cell carcinoma. PD-L1 immunohistochemistry staining found high expression of PD-L1 in nucleus. No abnormal result was found in baseline assessment of routine blood count, biochemistry analysis of blood, thyroid and adrenal cortex function. PD-1 antibody 200mg, d1, Q3w was used according to the instructions. In routine assessment before the second cycle of treatment, he was found hyperthyroidism and adrenal insufficiency, but the patient had not any related symptoms. Thus, the adverse effects were designated as grade 1, unnecessary for intervention. The serum tumor marker related to squamous cell carcinoma was significantly reduced, so he continued to receive the treatment according to previous schedule. During the assessment before the third cycle of treatment, the routine blood test and all serum tumor markers were found normal. Chest CT showed partial remission of the neoplasm according to RECIST criteria. There was no further deterioration in thyroid and adrenal cortex function, etc.
Conclusion:
Significant objective response to PD-1 antibody could be expected in first-line treatment of advanced squamous cell carcinoma of lung with high PD-L1 expression. but early-onset abnormal function of multi-organ may occur simultaneously which warrants intensive focus and follow-up.
