Symptomatic pseudo-progression followed by significant treatment response in two lung cancer patients treated with immunotherapy. (November 2017)

• Record Type: Journal Article
• Authors: Hochmair, Maximilian J.; Schwab, Sophia; Burghuber, Otto C.; Krenbek, Dagmar; Prosch, Helmut
• Is Part Of: Lung cancer. Volume 113(2017)
• Page Start: 4
• Page End: 6
• Publication Date: 2017-11
• Subjects: NSCLC -- Immunotherapy -- Pseudo-progression -- Pembrolizumab; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2017.08.020
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Pseudo-progression in patients receiving immunotherapy is linked to favorable survival. Discontinuation of immunotherapy is recommended if symptomatic pseudo-progression occurs. However, certain patients experiencing clinical deterioration might benefit from treatment beyond progression. The clinical presentation of pseudo-progression might vary across cancer types. Abstract: In the setting of pseudo-progression in a cancer patient who receives immunotherapeutic treatment, discontinuation of therapy is recommended if the patient is symptomatic. Here, we present two patients with advanced adenocarcinoma of the lung who developed massive tumor growth after initiation of treatment with the anti-PD-1 antibody pembrolizumab. Even though clinical deterioration occurred in the form of severe dyspnea and weight loss, pembrolizumab therapy was continued, as the speed of tumor growth suggested pseudo-progression and the tumors showed marked PD-L1 expression. This approach was successful, and both patients experienced impressive treatment responses within a few weeks.