Conversion therapy with chemoimmunotherapy induced pCR in a stage IV lung squamous cell carcinoma patient harboring EGFR exon 20 insertion
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 (p...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2024-12-01
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| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/21645515.2024.2431384 |
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| Summary: | 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. |
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| ISSN: | 2164-5515 2164-554X |