Nivolumab Induces Seven-Year Sustained Remission in a Patient with Advanced PD-L1-Positive Lung Adenocarcinoma: A Case Report

Hongmei ShengWei ZhangQihong YuXing Wanghaiying peng^*

• Tianjin Chest Hospital, Tianjin, China

Objective: To summarize the clinical experience of a patient with advanced non-small cell lung cancer (NSCLC) who achieved long-term survival after treatment with the programmed cell death protein 1 (PD-1) inhibitor nivolumab. Methods: We retrospectively analyzed the case of a 78-year-old male patient diagnosed in April 2018 with right lung adenocarcinoma (cT4N3M1a, stage IV). The patient was driver-gene negative but had a high PD-L1 tumor proportion score (TPS of 90%). He received five cycles of first-line chemotherapy with pemetrexed and cisplatin (PP regimen), which was followed by sequential maintenance therapy with nivolumab (200 mg, Q3W). Results: After initial response, the disease progressed following first-line chemotherapy. After switching to nivolumab, radiographic evaluation indicated a partial response (PR), which was subsequently assessed as an ongoing response. As of March 2025, the patient remains in continuous remission, with a progression-free survival (PFS) exceeding 82 months and an overall survival (OS) exceeding 84 months. Treatment-related adverse events were mild, and tolerance was excellent. Conclusion: For patients with PD-L1-high advanced NSCLC, nivolumab monotherapy can induce deep and durable immune responses, enabling long-term survival with a manageable safety profile, even in elderly patients with multiple comorbidities. This case provides compelling real-world evidence for the remarkable efficacy of immune checkpoint inhibitors.