A Long-term Response to Nivolumab in a Case of PD-L1-negative Lung Adenocarcinoma with an EGFR Mutation and Surrounding PD-L1-positive Tumor-associated Macrophages

Hiromi Watanabe; Kadoaki Ohashi; Kazuya Nishii; Keisuke Seike; Go Makimoto; Katsuyuki Hotta; Yoshinobu Maeda; Katsuyuki Kiura

doi:10.2169/internalmedicine.2875-19

CASE REPORTS

A Long-term Response to Nivolumab in a Case of PD-L1-negative Lung Adenocarcinoma with an EGFR Mutation and Surrounding PD-L1-positive Tumor-associated Macrophages

Hiromi Watanabe, Kadoaki Ohashi, Kazuya Nishii, Keisuke Seike, Go Makimoto, Katsuyuki Hotta, Yoshinobu Maeda, Katsuyuki Kiura

Author information

Hiromi Watanabe
Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Department of Respiratory Medicine, Okayama University Hospital, Japan
Kadoaki Ohashi
Department of Respiratory Medicine, Okayama University Hospital, Japan
Kazuya Nishii
Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Keisuke Seike
Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Go Makimoto
Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Katsuyuki Hotta
Department of Respiratory Medicine, Okayama University Hospital, Japan
Center for Innovative Clinical Medicine, Okayama University Hospital, Japan
Yoshinobu Maeda
Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
Katsuyuki Kiura
Department of Respiratory Medicine, Okayama University Hospital, Japan

Keywords: lung adenocarcinoma, EGFR mutations, nivolumab, tumor-associated macrophages

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 20 Pages 3033-3037

DOI https://doi.org/10.2169/internalmedicine.2875-19

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Abstract

Anti-programmed cell death 1 (PD-1) antibodies have poor efficacy in epidermal growth factor receptor (EGFR)-mutated lung cancer. We herein report a 72-year-old man with programmed cell death-ligand 1 (PD-L1)-negative lung adenocarcinoma harboring an EGFR mutation that responded to nivolumab for more than 2 years. A pathological examination revealed infiltration of CD8-positive lymphocytes and macrophages expressing CD68, CD206, and PD-L1 into the PD-L1-negative tumor; CD206 expression is a marker of immunosuppressive tumor-associated macrophages (TAMs). The presence of PD-L1-positive TAMs in the tumor environment might be a predictor of a positive response to anti-PD-1 antibodies.

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