Long-Lasting Pembrolizumab Response in Stage III Lung Adenocarcinoma With STK11, TP53 and RB1 Mutations
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage III
- Subtype
- Adenocarcinoma
- Biomarkers
- STK11, TP53 and RB1 mutations; high tumor mutational burden; PD-L1 70%
- Sex
- male
- Treatment
- chemotherapy, radiation and immunotherapy
- Outcome
- Responding Well
Treatment course, step by step
- Received concurrent carboplatin and paclitaxel with radiation.
- Chemotherapy was held during the final 2 weeks because of severe neutropenia.
- After early disease progression, started pembrolizumab every 3 weeks and continued it for more than 2 years.
What happened, in summary
A 68-year-old man with a smoking history and COPD was diagnosed with Stage III lung adenocarcinoma after imaging found a large mediastinal mass and a lymph-node biopsy showed metastatic adenocarcinoma. Molecular testing found STK11, TP53, and RB1 mutations, a high tumor mutational burden, and PD-L1 expression of 70%.
He began combined radiation with carboplatin and paclitaxel. Severe neutropenia required the chemotherapy to be held during the final 2 weeks, although he completed the radiation course. Soon afterward, imaging showed disease progression with enlarging lymph nodes and a new lung mass.
Pembrolizumab was then started as second-line immunotherapy. Within 3 months, his breathing and fatigue improved and imaging showed a partial response. He tolerated treatment without significant immune-related toxicity and continued pembrolizumab for more than 2 years. The durable response was notable because STK11 alterations are often associated with more difficult treatment outcomes, while this tumor also had high PD-L1 expression and a high mutation burden.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
How we source and attribute stories Accuracy and limitations
Collections this story belongs to
- Stage 3 Lung Cancer 77 stories
- TP53 Mutation Lung Cancer 19 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