Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical case

Lung cancer remains a leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for the majority of cases. Among its subtypes, adenocarcinoma is most prevalent. Stage IV NSCLC comes with a poor prognosis, particularly in elderly patients with comorbidities. Progra...

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Main Authors: A. Chehal, A. ALakkad, H. Alkaabi, A. A. Razek, Y. Z. Alabed, H. M. Almasarei
Format: Article
Language:Russian
Published: Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University) 2025-07-01
Series:Сеченовский вестник
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Online Access:https://www.sechenovmedj.com/jour/article/view/1330
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author A. Chehal
A. ALakkad
H. Alkaabi
A. A. Razek
Y. Z. Alabed
H. M. Almasarei
author_facet A. Chehal
A. ALakkad
H. Alkaabi
A. A. Razek
Y. Z. Alabed
H. M. Almasarei
author_sort A. Chehal
collection DOAJ
description Lung cancer remains a leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for the majority of cases. Among its subtypes, adenocarcinoma is most prevalent. Stage IV NSCLC comes with a poor prognosis, particularly in elderly patients with comorbidities. Programmed death-ligand 1 (PD-L1) checkpoint inhibitors have demonstrated promising efficacy, including in cases with brain metastases.Case report. The case concerns an 83-year-old woman with diabetes mellitus, arterial hypertension, and atrial fibrillation, diagnosed with stage IVB poorly differentiated lung adenocarcinoma which was confirmed by a percutaneous lung biopsy. PD-L1 expression was 40%. Magnetic resonance imaging identified a solitary brain metastasis. The patient was treated with dexamethasone and a CheckMate 9LA protocol was initiated with reduced-dose carboplatin, pemetrexed, nivolumab, and ipilimumab. A two years follow-up positron emission tomography showed a significant reduction in lung cancer. The brain lesions had almost disappeared, and in addition a clinical improvement could be observed.Discussion. This case underscores the potential for durable remission and improved quality of life through individualized treatment strategies in older patients with advanced NSCLC and brain involvement
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institution DOAJ
issn 2218-7332
2658-3348
language Russian
publishDate 2025-07-01
publisher Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
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series Сеченовский вестник
spelling doaj-art-e2d1bd407c7343c38bb77f8636815a292025-08-20T03:20:26ZrusFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Сеченовский вестник2218-73322658-33482025-07-01162526010.47093/2218-7332.2025.16.2.52-60623Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical caseA. Chehal0A. ALakkad1H. Alkaabi2A. A. Razek3Y. Z. Alabed4H. M. Almasarei5Sheikh Shakhbout Medical City; Gulf Medical UniversityMadinat Zayed HospitalSheikh Shakhbout Medical CityGulf International Cancer CenterGulf International Cancer CenterMadinat Zayed HospitalLung cancer remains a leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for the majority of cases. Among its subtypes, adenocarcinoma is most prevalent. Stage IV NSCLC comes with a poor prognosis, particularly in elderly patients with comorbidities. Programmed death-ligand 1 (PD-L1) checkpoint inhibitors have demonstrated promising efficacy, including in cases with brain metastases.Case report. The case concerns an 83-year-old woman with diabetes mellitus, arterial hypertension, and atrial fibrillation, diagnosed with stage IVB poorly differentiated lung adenocarcinoma which was confirmed by a percutaneous lung biopsy. PD-L1 expression was 40%. Magnetic resonance imaging identified a solitary brain metastasis. The patient was treated with dexamethasone and a CheckMate 9LA protocol was initiated with reduced-dose carboplatin, pemetrexed, nivolumab, and ipilimumab. A two years follow-up positron emission tomography showed a significant reduction in lung cancer. The brain lesions had almost disappeared, and in addition a clinical improvement could be observed.Discussion. This case underscores the potential for durable remission and improved quality of life through individualized treatment strategies in older patients with advanced NSCLC and brain involvementhttps://www.sechenovmedj.com/jour/article/view/1330pulmonary adenocarcinomacentral nervous system metastasispoorly differentiated adenocarcinomapd-l1 expressionimmune checkpoint inhibitorspersonalized treatment
spellingShingle A. Chehal
A. ALakkad
H. Alkaabi
A. A. Razek
Y. Z. Alabed
H. M. Almasarei
Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical case
Сеченовский вестник
pulmonary adenocarcinoma
central nervous system metastasis
poorly differentiated adenocarcinoma
pd-l1 expression
immune checkpoint inhibitors
personalized treatment
title Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical case
title_full Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical case
title_fullStr Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical case
title_full_unstemmed Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical case
title_short Complete remission in an elderly patient with non-small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy: a clinical case
title_sort complete remission in an elderly patient with non small cell lung cancer and brain metastasis using immunotherapy plus chemotherapy a clinical case
topic pulmonary adenocarcinoma
central nervous system metastasis
poorly differentiated adenocarcinoma
pd-l1 expression
immune checkpoint inhibitors
personalized treatment
url https://www.sechenovmedj.com/jour/article/view/1330
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