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Case Report ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2019.00819

Dramatic response of leptomeningeal carcinomatosis to nivolumab in PD-L1 highly expressive non-small cell lung cancer: a case report.

 DAVID A. RON1*,  Carmen M. L. Guerra2, 3, Maria Carmen A. Manrique1, Paula S. Domarco1, Ihab A. Nallib4,  Jesus G. Mata1,  Christian R. Rolfo, MD, PhD, MBA5, Diego G. Rivas6 and  Jose Luis F. Perez1*
  • 1Complejo Hospitalario de Ourense, Spain
  • 2Fundación Biomédica Galicia Sur, Spain
  • 3Hospital Álvaro Cunqueiro, Spain
  • 4University of Santiago de Compostela, Spain
  • 5Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland Medical Center, United States
  • 6Shanghai Pulmonary Hospital, School of Medicine, Tongji University, China

In a patient who had been diagnosed of located squamous cell lung carcinoma, pneumonectomy and adjuvant chemotherapy were performed. Brain recurrence and subsequent lung metastatic disease were uncontrolled by neurosurgery, holocranial radiotherapy and first-line chemotherapy. In August 2015, appearance of leptomeningeal carcinomatosis triggered severe clinical deterioration and threatened the patient's life. Anti-PD1 immune checkpoint inhibitor Nivolumab was initiated in an attempt to stop tumour growth, achieving a spectacular brain and pulmonary complete response and clinical improvement, without serious adverse effects. High expression PD-L1 level (100%) was found in the pathological tissue sample. Nivolumab was maintained for more than two years and stopped in December 2017 after 28 months of treatment, with no disease evidence. More than three years after its onset, the patient maintains an outstanding PS with complete tumour response and no evidence of disease in last surveillance CT scan and brain MRI.

Keywords: Squamous lung cancer, Nivolumab, Leptomeningeal carcinomatosis, PDL1, complete response (CR)

Received: 02 Jul 2019; Accepted: 09 Aug 2019.

Edited by:

Antonio Calles, Gregorio Marañón Hospital, Spain

Reviewed by:

Lucio Buffoni, Ospedale San Luigi Gonzaga, Italy
Laura Mezquita, Institut Gustave Roussy, France  

Copyright: © 2019 RON, Guerra, Manrique, Domarco, Nallib, Mata, Rolfo, MD, PhD, MBA, Rivas and Perez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. DAVID A. RON, Complejo Hospitalario de Ourense, Ourense, Spain, david.arias.ron@gmail.com
Dr. Jose Luis F. Perez, Complejo Hospitalario de Ourense, Ourense, Spain, Jose.luis.firvida.perez@sergas.es