Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung Adenocarcinoma
Immunotherapy has become the standard of care for advanced and resectable lung cancer, and specific mutations may predict immunotherapy response. For example, STK11 mutations, which are more common in African American patients, are associated with immunotherapy resistance. A 68-year-old African Amer...
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| Language: | English |
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SAGE Publishing
2025-05-01
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| Series: | Journal of Investigative Medicine High Impact Case Reports |
| Online Access: | https://doi.org/10.1177/23247096251346830 |
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| author | Yaolin Zhou Maneesh Gaddam Sunil Badami |
| author_facet | Yaolin Zhou Maneesh Gaddam Sunil Badami |
| author_sort | Yaolin Zhou |
| collection | DOAJ |
| description | Immunotherapy has become the standard of care for advanced and resectable lung cancer, and specific mutations may predict immunotherapy response. For example, STK11 mutations, which are more common in African American patients, are associated with immunotherapy resistance. A 68-year-old African American man with stage IIIB lung adenocarcinoma with mediastinal lymph node involvement progressed on first-line concurrent carboplatin-based chemoradiotherapy. Molecular testing of the patient’s subcarinal lymph node tissue revealed STK11 S216F, TP53 R273L, and RB1 splice site mutations; high tumor mutation burden (19.0 mutations/Mb); and high PD-L1 22c3 expression (TPS 70%, 2+ intensity). Treatment with carboplatin-based chemotherapy with radiation therapy failed to control the disease, but the patient has tolerated and responded well to intravenous pembrolizumab. Although STK11 mutations are associated with immunotherapy resistance, our patient demonstrated an exceptional and sustained response to immunotherapy for over two years. The patient’s STK11/TP53 co-mutation, along with high TMB and PD-L1 22c3 TPS scores, may help explain his continued responsiveness to immunotherapy and longer survival. Importantly, incorporating genetic ancestry differences in mutation prevalence and the impact of specific mutations and co-mutations, may help ensure the equitable and optimal treatment of all patients with lung cancers. |
| format | Article |
| id | doaj-art-17eee495a664488286350dbeb955e3d3 |
| institution | OA Journals |
| issn | 2324-7096 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Investigative Medicine High Impact Case Reports |
| spelling | doaj-art-17eee495a664488286350dbeb955e3d32025-08-20T02:01:06ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962025-05-011310.1177/23247096251346830Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung AdenocarcinomaYaolin Zhou0Maneesh Gaddam1Sunil Badami2Department of Pathology and Laboratory Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USADivision of Pulmonary, Critical Care and Sleep Medicine, Appalachian Regional Healthcare, Hazard, KY, USADivision of Hematology-Oncology in the Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USAImmunotherapy has become the standard of care for advanced and resectable lung cancer, and specific mutations may predict immunotherapy response. For example, STK11 mutations, which are more common in African American patients, are associated with immunotherapy resistance. A 68-year-old African American man with stage IIIB lung adenocarcinoma with mediastinal lymph node involvement progressed on first-line concurrent carboplatin-based chemoradiotherapy. Molecular testing of the patient’s subcarinal lymph node tissue revealed STK11 S216F, TP53 R273L, and RB1 splice site mutations; high tumor mutation burden (19.0 mutations/Mb); and high PD-L1 22c3 expression (TPS 70%, 2+ intensity). Treatment with carboplatin-based chemotherapy with radiation therapy failed to control the disease, but the patient has tolerated and responded well to intravenous pembrolizumab. Although STK11 mutations are associated with immunotherapy resistance, our patient demonstrated an exceptional and sustained response to immunotherapy for over two years. The patient’s STK11/TP53 co-mutation, along with high TMB and PD-L1 22c3 TPS scores, may help explain his continued responsiveness to immunotherapy and longer survival. Importantly, incorporating genetic ancestry differences in mutation prevalence and the impact of specific mutations and co-mutations, may help ensure the equitable and optimal treatment of all patients with lung cancers.https://doi.org/10.1177/23247096251346830 |
| spellingShingle | Yaolin Zhou Maneesh Gaddam Sunil Badami Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung Adenocarcinoma Journal of Investigative Medicine High Impact Case Reports |
| title | Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung Adenocarcinoma |
| title_full | Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung Adenocarcinoma |
| title_fullStr | Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung Adenocarcinoma |
| title_full_unstemmed | Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung Adenocarcinoma |
| title_short | Exceptional Long-term Response to Immunotherapy in an African American Man With -Mutated Metastatic Lung Adenocarcinoma |
| title_sort | exceptional long term response to immunotherapy in an african american man with mutated metastatic lung adenocarcinoma |
| url | https://doi.org/10.1177/23247096251346830 |
| work_keys_str_mv | AT yaolinzhou exceptionallongtermresponsetoimmunotherapyinanafricanamericanmanwithmutatedmetastaticlungadenocarcinoma AT maneeshgaddam exceptionallongtermresponsetoimmunotherapyinanafricanamericanmanwithmutatedmetastaticlungadenocarcinoma AT sunilbadami exceptionallongtermresponsetoimmunotherapyinanafricanamericanmanwithmutatedmetastaticlungadenocarcinoma |