Pleomorphic lung cancer responding to pembrolizumab plus chemotherapy
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Biomarkers
- PD-L1 tumor proportion score >75%; EGFR negative; ROS1 negative; ALK fusion negative
- Sex
- Male
- Spread to
- right 8th rib, left adrenal gland
- Treatment
- chemotherapy and immunotherapy
- Outcome
- Responding Well
Treatment course, step by step
- Started pembrolizumab 200 mg, carboplatin AUC 5 and paclitaxel 180 mg/m² every 28 days.
- Imaging after 3 cycles showed shrinkage of the lung tumor and mediastinal lymph nodes.
- Completed 6 cycles of combination therapy.
- Maintenance pembrolizumab was planned after the 6 combination cycles.
What happened, in summary
A 60-year-old man who had never smoked presented with chest and back-of-head discomfort and general fatigue. Imaging found a 3 cm tumor in the left lung with enlarged mediastinal lymph nodes, plus metastases to the right 8th rib and left adrenal gland. His disease was Stage IV.
His performance status worsened quickly during the diagnostic work-up, so treatment began with pembrolizumab 200 mg, carboplatin AUC 5 and paclitaxel 180 mg/m² every 28 days. After 3 cycles, imaging showed shrinkage of the lung tumor and mediastinal nodes, and his general condition improved. He completed 6 cycles. The most notable toxicity described was grade II anorexia.
Final pathology established pleomorphic carcinoma of the lung. Tumor testing showed a PD-L1 tumor proportion score above 75%, with no EGFR or ROS1 mutation and no ALK fusion.
Seven months after diagnosis, he remained well following the response to combination treatment. Maintenance pembrolizumab was planned after the 6 cycles of pembrolizumab plus chemotherapy.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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Collections this story belongs to
- Stage 4 Lung Cancer 384 stories
- Carboplatin for Stage 4 Lung Cancer 104 stories
- Carboplatin for Lung Cancer 168 stories
These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer