Overcoming resistance to anti-PD-1 immunotherapy in lymphoepithelioma-like carcinoma: A case report and review of the literature. (August 2020)

• Record Type: Journal Article
• Authors: Tang, Zhengwu; Fang, Rui; Tong, Guihui; Liu, Peng; Ou, Zhu'an; Tang, Yong
• Is Part Of: Lung cancer. Volume 146(2020)
• Page Start: 335
• Page End: 340
• Publication Date: 2020-08
• Subjects: Immune checkpoint inhibitor -- Immunotherapy -- Lymphoepithelioma-like carcinoma; 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.2020.06.027
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare form of NSCLC. Treatment strategies for advanced-stage LELC rely on chemotherapy and radiotherapy. Immunotherapy might be an effective approach for patients with LELC. Addition chemotherapy can overcome resistance to mono-immunotherapy. Abstract: Objectives: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small-cell lung cancer with no established treatment protocols. Immunotherapy is rarely used as a second-line choice in patients with advanced LELC, and more cases of this condition should be presented. Materials and methods: We present a patient with advanced primary pulmonary LELC overcoming the resistance to second-line anti-programmed death-1 (PD-1) immunotherapy. We also review the literature to summarize the current immunotherapy landscape of this rare disorder. Results and conclusion: The LELC patient progressed after first-line chemotherapy, was treated by immunotherapy alone and progressed again. To overcome the developed resistance to immunotherapy, chemotherapy with nedaplatin plus paclitaxel in addition to nivolumab was administered and a progression-free survival (PFS) of 5 months was achieved. It was also observed that the blood levels of neuron-specific enolase may act as an efficacy biomarker in LELC. Patients with this rare disorder resistant to anti-PD-1 immunotherapy might benefit from therapy based on PD-1 inhibition; this is a future avenue of research.