Case Report: Complete Response to Nivolumab in a Patient With Programmed Cell Death 1 Ligand 1-Positive and Multiple Gene-Driven Anaplastic Lymphoma Kinase Tyrosine Kinase Inhibitor-Resistant Lung Adenocarcinoma

被引:0
|
作者
Dong, Wen [1 ]
Lei, Pengfei [2 ]
Liu, Xin [3 ]
Li, Qin [3 ]
Cheng, Xiangyang [4 ]
机构
[1] Hainan Canc Hosp, Dept Resp Med, Haikou, Hainan, Peoples R China
[2] Yueyang Second Peoples Hosp, Dept Cardiothorac Surg, Yueyang, Peoples R China
[3] Geneplus Beijing Inst, Dept Med Ctr, Beijing, Peoples R China
[4] Guangzhou Med Univ, Affiliated Hosp 1, Guangzhou Inst Resp Hlth, State Key Lab Resp Dis,Natl Clin Res Ctr Resp Dis, Guangzhou, Peoples R China
来源
FRONTIERS IN IMMUNOLOGY | 2021年 / 12卷
关键词
lung cancer; EML4-ALK; nivolumab; complete remission; PD-L1; ALK; MUTATIONS; OUTCOMES; PATHWAY; CANCER; EGFR;
D O I
10.3389/fimmu.2021.686057
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Multiple gene-driven programmed cell death 1 ligand 1 (PD-L1)-expressing non-small-cell lung cancer (NSCLC) is very rare. Previous studies have shown that patients with NSCLC with anaplastic lymphoma kinase (ALK) gene rearrangement rarely benefit from PD-L1 inhibitors. Besides the secondary mutations in ALK gene, other mechanisms might contribute to tumor resistance to ALK tyrosine kinase inhibitors (ALK-TKIs). Herein, we present a case of PD-L1-overexpressing lung adenocarcinoma that harbors both EML4-ALK gene rearrangement and BRAF mutation. In particular, a second molecular analysis after resistance to first- and second-generation ALK-TKIs revealed a high PD-L1 expression and tumor mutation burden. Therefore, treatment with nivolumab monotherapy, an anti-PD-1 inhibitor, was started and the patient achieved complete remission. This case report suggested that PD-1 inhibitors might be an effective treatment option for patients with multiple gene-driven PD-L1-expressing NSCLC harboring ALK gene rearrangement.
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页数:5
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