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Published in: Journal of Medical Case Reports 1/2017

Open Access 01-12-2017 | Case report

Partial response of pulmonary adenocarcinoma with symptomatic brain metastasis to nivolumab plus high-dose oral corticosteroid: a case report

Published in: Journal of Medical Case Reports | Issue 1/2017

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Abstract

Background

Nivolumab, a monoclonal antibody targeting the programmed death-1 receptor, is indicated in locally advanced or metastatic non-small cell lung cancer, with progression after platinum-based chemotherapy. Up-to-now, few data are available concerning brain activity of this treatment and concomitant use of corticosteroids.

Case presentation

A 64-year-old caucasian man with a pulmonary adenocarcinoma associated with brain metastases received four courses of nivolumab in concomitance with a high dose of corticosteroids for his neurologic symptoms. He experienced a partial response in his brain and chest with an improvement in his general condition.
Nivolumab was effective in shrinking symptomatic brain metastases, and metastases at other sites, in a patient with non-small cell lung cancer and first-line chemotherapy failure. The effect of nivolumab was obtained despite concomitant high-dose corticosteroid therapy. Combined nivolumab and high-dose corticosteroid therapy did not induce unexpected adverse events.

Conclusion

Nivolumab and concomitant high-dose corticosteroid therapy was found to be efficient and well tolerated.
Literature
1.
go back to reference Borghaei H, Paz-Ares L, Horn L, Spigel DR, Steins M, Ready NE, et al. Nivolumab versus Docetaxel in Advanced Nonsquamous Non–Small-Cell Lung Cancer. N Engl J Med. 2015;373(17):1627–39.CrossRefPubMed Borghaei H, Paz-Ares L, Horn L, Spigel DR, Steins M, Ready NE, et al. Nivolumab versus Docetaxel in Advanced Nonsquamous Non–Small-Cell Lung Cancer. N Engl J Med. 2015;373(17):1627–39.CrossRefPubMed
2.
go back to reference Brahmer J, Reckamp KL, Baas P, Crinò L, Eberhardt WEE, Poddubskaya E, et al. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non–Small-Cell Lung Cancer. N Engl J Med. 2015;373(2):123–35.CrossRefPubMedPubMedCentral Brahmer J, Reckamp KL, Baas P, Crinò L, Eberhardt WEE, Poddubskaya E, et al. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non–Small-Cell Lung Cancer. N Engl J Med. 2015;373(2):123–35.CrossRefPubMedPubMedCentral
3.
go back to reference Ettinger DS, Wood DE, Akerley W, Bazhenova LA, Borghaei H, Camidge DR, et al. NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 4.2016. J Natl Compr Cancer Netw JNCCN. 2016;14(3):255–64.CrossRefPubMed Ettinger DS, Wood DE, Akerley W, Bazhenova LA, Borghaei H, Camidge DR, et al. NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 4.2016. J Natl Compr Cancer Netw JNCCN. 2016;14(3):255–64.CrossRefPubMed
5.
go back to reference Leighl N, Gandhi L, Hellmann MD, Horn L, Ahn MJ, Garon EB, et al. Pembrolizumab for NSCLC Immune-Mediated Adverse Events and Corticosteroid Use. Oral sessions. J Thorac Oncol. 2015;10(9):S173–260. Leighl N, Gandhi L, Hellmann MD, Horn L, Ahn MJ, Garon EB, et al. Pembrolizumab for NSCLC Immune-Mediated Adverse Events and Corticosteroid Use. Oral sessions. J Thorac Oncol. 2015;10(9):S173–260.
6.
go back to reference Gettinger SN, Horn L, Ramalingam SS, Spigel DR, Paz-Ares L, Paik P, et al. 3094 Nivolumab (NIVO) safety profile: Summary of findings from trials in patients (pts) with advanced squamous (SQ) non-small cell lung cancer (NSCLC). Eur J Cancer. 2015;51:S631.CrossRef Gettinger SN, Horn L, Ramalingam SS, Spigel DR, Paz-Ares L, Paik P, et al. 3094 Nivolumab (NIVO) safety profile: Summary of findings from trials in patients (pts) with advanced squamous (SQ) non-small cell lung cancer (NSCLC). Eur J Cancer. 2015;51:S631.CrossRef
7.
go back to reference Rothermundt C, Hader C, Gillessen S. Successful treatment with an anti-PD-1 antibody for progressing brain metastases in renal cell cancer. Ann Oncol. 2016;27(3):544–5.CrossRefPubMed Rothermundt C, Hader C, Gillessen S. Successful treatment with an anti-PD-1 antibody for progressing brain metastases in renal cell cancer. Ann Oncol. 2016;27(3):544–5.CrossRefPubMed
8.
go back to reference Carter T, Shaw H, Cohn-Brown D, Chester K, Mulholland P. Ipilimumab and Bevacizumab in Glioblastoma. Clin Oncol (R Coll Radiol). 2016;28(10):622–6.CrossRef Carter T, Shaw H, Cohn-Brown D, Chester K, Mulholland P. Ipilimumab and Bevacizumab in Glioblastoma. Clin Oncol (R Coll Radiol). 2016;28(10):622–6.CrossRef
9.
go back to reference Margolin K, Ernstoff MS, Hamid O, Lawrence D, McDermott D, Puzanov I, et al. Ipilimumab in patients with melanoma and brain metastases: an open-label, phase 2 trial. Lancet Oncol. 2012;13(5):459–65.CrossRefPubMed Margolin K, Ernstoff MS, Hamid O, Lawrence D, McDermott D, Puzanov I, et al. Ipilimumab in patients with melanoma and brain metastases: an open-label, phase 2 trial. Lancet Oncol. 2012;13(5):459–65.CrossRefPubMed
10.
go back to reference Kanai O, Fujita K, Okamura M, Nakatani K, Mio T. Severe exacerbation or manifestation of primary disease related to nivolumab in non-small-cell lung cancer patients with poor performance status or brain metastases. Ann Oncol. 2016;27(7):1354–6.CrossRefPubMed Kanai O, Fujita K, Okamura M, Nakatani K, Mio T. Severe exacerbation or manifestation of primary disease related to nivolumab in non-small-cell lung cancer patients with poor performance status or brain metastases. Ann Oncol. 2016;27(7):1354–6.CrossRefPubMed
12.
go back to reference Cortinovis D, Delmonte A, Chiari R, Catino A, Grossi F, Noberasco C, et al. P3.02c-094 Italian Nivolumab Advanced Squamous NSCLC Expanded Access Program: Efficacy and Safety in Patients with Brain Metastases. J Thorac Oncol. 2017;12(1):S1336.CrossRef Cortinovis D, Delmonte A, Chiari R, Catino A, Grossi F, Noberasco C, et al. P3.02c-094 Italian Nivolumab Advanced Squamous NSCLC Expanded Access Program: Efficacy and Safety in Patients with Brain Metastases. J Thorac Oncol. 2017;12(1):S1336.CrossRef
13.
go back to reference Lukas RV, Kumthekar P, Rizvi S, Salgia R. Systemic therapies in the treatment of non-small-cell lung cancer brain metastases. Future Oncol Lond Engl. 2016;12(8):1045–58.CrossRef Lukas RV, Kumthekar P, Rizvi S, Salgia R. Systemic therapies in the treatment of non-small-cell lung cancer brain metastases. Future Oncol Lond Engl. 2016;12(8):1045–58.CrossRef
14.
go back to reference Bui N, Woodward B, Johnson A, Husain H. Novel Treatment Strategies for Brain Metastases in Non-small-cell Lung Cancer. Curr Treat Options Oncol [Internet]. 2016;17(5). doi:10.1007/s11864-016-0400-x Bui N, Woodward B, Johnson A, Husain H. Novel Treatment Strategies for Brain Metastases in Non-small-cell Lung Cancer. Curr Treat Options Oncol [Internet]. 2016;17(5). doi:10.​1007/​s11864-016-0400-x
Metadata
Title
Partial response of pulmonary adenocarcinoma with symptomatic brain metastasis to nivolumab plus high-dose oral corticosteroid: a case report
Publication date
01-12-2017
Published in
Journal of Medical Case Reports / Issue 1/2017
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-017-1334-z

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