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

Yoshiro Nakahara; Tomoya Fukui; Masayuki Shirasawa; Shinya Harada; Seiichiro Kusuhara; Akira Takakura; Masanori Yokoba; Hisashi Mitsufuji; Masaru Kubota; Masato Katagiri; Jiichiro Sasaki; Noriyuki Masuda; Madoka Inukai; Tomoko Sekiguchi; Katsuhiko Naoki

doi:10.2169/internalmedicine.9884-17

CASE REPORTS

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

Yoshiro Nakahara, Tomoya Fukui, Masayuki Shirasawa, Shinya Harada, Seiichiro Kusuhara, Akira Takakura, Masanori Yokoba, Hisashi Mitsufuji, Masaru Kubota, Masato Katagiri, Jiichiro Sasaki, Noriyuki Masuda, Madoka Inukai, Tomoko Sekiguchi, Katsuhiko Naoki

Author information

Yoshiro Nakahara
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Tomoya Fukui
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Masayuki Shirasawa
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Shinya Harada
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Seiichiro Kusuhara
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Akira Takakura
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Masanori Yokoba
Department of Medical Laboratory, Kitasato University School of Allied Health Sciences, Japan
Hisashi Mitsufuji
Kitasato University School of Nursing, Japan
Masaru Kubota
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Masato Katagiri
Department of Medical Laboratory, Kitasato University School of Allied Health Sciences, Japan
Jiichiro Sasaki
Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Japan
Noriyuki Masuda
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan
Madoka Inukai
Department of Pathology, Kitasato University School of Medicine, Japan
Tomoko Sekiguchi
Department of Neurosurgery, Kitasato University School of Medicine, Japan
Katsuhiko Naoki
Department of Respiratory Medicine, Kitasato University School of Medicine, Japan

Keywords: brain metastasis, nivolumab, lung cancer

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 21 Pages 3149-3152

DOI https://doi.org/10.2169/internalmedicine.9884-17

Browse “Advance online publication” version

Details

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.

Corresponding author

Register with J-STAGE for free!