{"title":"Conversion therapy with chemoimmunotherapy induced pCR in a stage IV lung squamous cell carcinoma patient harboring <i>EGFR</i> exon 20 insertion.","authors":"Mingjin Xu, Xingfa Huo, Chuantao Zhang, Xuchen Zhang, Huiyun Wang, Hongmin Yang, Nan Ge, Yongjie Wang, Helei Hou","doi":"10.1080/21645515.2024.2431384","DOIUrl":null,"url":null,"abstract":"<p><p>This case study details an innovative conversion therapy strategy in a 58-year-old Asian male with baseline stage cT<sub>4</sub>N<sub>1</sub>M<sub>1b</sub> advanced lung squamous cell carcinoma (SCC) harboring a rare <i>EGFR</i> exon 20 insertion mutation with concurrent high PD-L1 expression who achieved a pathologic complete response (pCR) after preoperative immunotherapy plus chemotherapy. The patient initially presented with coughing and bloody sputum and was comprehensively diagnosed via PET/CT scanning, bronchoscopic biopsy and next-generation sequencing. After four cycles of platinum‒paclitaxel chemotherapy plus immunotherapy with pembrolizumab (a PD-1 blockade), significant primary tumor shrinkage and the disappearance of oligometastasis in the right adrenal gland were discovered via CT scans. The subsequent salvage lung surgery resulted in a pCR, and the patient continued postoperative maintenance immunotherapy. No evidence of disease relapse or immune-related adverse events occurred after a post-surgery follow-up time of 9.4 months. This case highlights the potential value and challenges of immunotherapy plus chemotherapy as conversion therapy strategy in treating patients with non-small cell lung cancer (NSCLC) harboring rare <i>EGFR</i> exon 20 insertions.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"20 1","pages":"2431384"},"PeriodicalIF":4.1000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610548/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human Vaccines & Immunotherapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/21645515.2024.2431384","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
This case study details an innovative conversion therapy strategy in a 58-year-old Asian male with baseline stage cT4N1M1b advanced lung squamous cell carcinoma (SCC) harboring a rare EGFR exon 20 insertion mutation with concurrent high PD-L1 expression who achieved a pathologic complete response (pCR) after preoperative immunotherapy plus chemotherapy. The patient initially presented with coughing and bloody sputum and was comprehensively diagnosed via PET/CT scanning, bronchoscopic biopsy and next-generation sequencing. After four cycles of platinum‒paclitaxel chemotherapy plus immunotherapy with pembrolizumab (a PD-1 blockade), significant primary tumor shrinkage and the disappearance of oligometastasis in the right adrenal gland were discovered via CT scans. The subsequent salvage lung surgery resulted in a pCR, and the patient continued postoperative maintenance immunotherapy. No evidence of disease relapse or immune-related adverse events occurred after a post-surgery follow-up time of 9.4 months. This case highlights the potential value and challenges of immunotherapy plus chemotherapy as conversion therapy strategy in treating patients with non-small cell lung cancer (NSCLC) harboring rare EGFR exon 20 insertions.
期刊介绍:
(formerly Human Vaccines; issn 1554-8619)
Vaccine research and development is extending its reach beyond the prevention of bacterial or viral diseases. There are experimental vaccines for immunotherapeutic purposes and for applications outside of infectious diseases, in diverse fields such as cancer, autoimmunity, allergy, Alzheimer’s and addiction. Many of these vaccines and immunotherapeutics should become available in the next two decades, with consequent benefit for human health. Continued advancement in this field will benefit from a forum that can (A) help to promote interest by keeping investigators updated, and (B) enable an exchange of ideas regarding the latest progress in the many topics pertaining to vaccines and immunotherapeutics.
Human Vaccines & Immunotherapeutics provides such a forum. It is published monthly in a format that is accessible to a wide international audience in the academic, industrial and public sectors.