Complete Response of a Patient with Lung Squamous Cell Carcinoma After Only Three Administrations of Nivolumab

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  • Fujimoto Sakae
    Department of Pulmonary Medicine, Gunma Prefectural Cancer Center
  • Fujita Atsushi
    Department of Thoracic Surgery, Gunma Prefectural Cancer Center
  • Minato Koichi
    Department of Pulmonary Medicine, Gunma Prefectural Cancer Center
  • Iijima Misa
    Department of Clinical Pathology, Gunma Prefectural Cancer Center

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Other Title
  • ニボルマブ3回投与のみで完全奏効となった肺扁平上皮癌の1例

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Abstract

<p>Background. Nivolumab is a programmed death (PD)-1 antibody that activates T cells by inhibiting the binding of T cells expressing PD-1 to a tumor expressing PD-ligand 1 (PD-L1). However, since immunosuppressive cells are involved in in vivo tumor immunity, nivolumab-activated T cells are suppressed. Although achieving a complete response (CR) using only nivolumab as a single agent would be difficult from the viewpoint of tumor immunology, such CR cases have been reported recently. We herein report a patient with lung squamous cell carcinoma who achieved a CR following only three administrations of nivolumab. Case. An 80-year-old Japanese man was admitted to our hospital following a medical examination's abnormal results. Based on a further evaluation, he was diagnosed with lung squamous cell carcinoma of the left upper lobe (cT4N3M1a stage IV). He also had eosinophilia in the blood and eosinophil infiltration in the tumor tissue. He received docetaxel as first-line therapy for four cycles and S-1 as second-line therapy for three cycles. After further progressive disease, nivolumab (3 mg/kg every 2 weeks) was intravenously administered three times as a third-line therapy, but it was discontinued due to a thyroid hormone abnormality. Blood eosinophils rapidly increased after the first administration, and the primary lesion was cavitated at two months after the third administration. He achieved a CR with remaining scar tissue by five months after the third administration. There has been no recurrence of lung cancer, but the patient's blood eosinophilia persisted at 21 months after the third administration. Conclusion. Eosinophils may be involved in a tumor's immune response to nivolumab, since our patient achieved a CR and his blood eosinophils rapidly increased following only three administrations of nivolumab.</p>

Journal

  • Haigan

    Haigan 58 (4), 292-297, 2018-08-20

    The Japan Lung Cancer Society

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