Please use this identifier to cite or link to this item:
https://doi.org/10.21037/tlcr-21-380
Title: | Complete disease remission in a <i>TP53</i> and <i>KRAS</i> co-mutated brain oligometastatic lung cancer patient after immuno-chemotherapy and surgical resection: a case report | Authors: | Zhu, Shuai Zhao, Shikang Zhang, Qian Li, Shuo Ren, Dian Ren, Fan Zu, Lingling Wang, Yanye Lei, Xi Zhou, Ning Shi, Tao Xu, Dongbo Chen, Gang Lim, Wan-Teck Giusti, Raffaele Wu, Abraham J Xu, Song |
Keywords: | Science & Technology Life Sciences & Biomedicine Oncology Respiratory System Oligometastatic non-small cell lung carcinoma (NSCLC) immuno-chemotherapy surgical resection case report |
Issue Date: | May-2021 | Publisher: | AME PUBLISHING COMPANY | Citation: | Zhu, Shuai, Zhao, Shikang, Zhang, Qian, Li, Shuo, Ren, Dian, Ren, Fan, Zu, Lingling, Wang, Yanye, Lei, Xi, Zhou, Ning, Shi, Tao, Xu, Dongbo, Chen, Gang, Lim, Wan-Teck, Giusti, Raffaele, Wu, Abraham J, Xu, Song (2021-05). Complete disease remission in a TP53 and KRAS co-mutated brain oligometastatic lung cancer patient after immuno-chemotherapy and surgical resection: a case report. TRANSLATIONAL LUNG CANCER RESEARCH 10 (5) : 2298-2305. ScholarBank@NUS Repository. https://doi.org/10.21037/tlcr-21-380 | Abstract: | Lung cancer is the most common primary malignancy and tends to metastasize to the brain. A multimodal approach, including systematic therapy (targeted therapy, chemotherapy, immunotherapy) and local consolidative therapy (surgical intervention, radiation therapy, ablation therapy), is essential for treatment of oligometastatic lung cancer. The systemic immunotherapy has been shown to increase response rate and survival, which then has the potential benefit of making localized treatment more feasible for some cases of oligometastatic cancer. We present a 62-year-old male with stage IVB lung adenocarcinoma with five metastases in the brain. Molecular testing exhibited KRAS and TP53 co-mutation, with negative PDL1 expression. The patient received six cycles of platinum-based chemotherapy plus pembrolizumab and minimally invasive lobectomy, followed by maintenance therapy with pemetrexed and pembrolizumab. The patient achieved complete disease remission, with no sign of recurrence for 22 months post-treatment. Moreover, we investigated PD-L1 expression and infiltration of immunological cells in biopsy tissue and surgical specimen prior to and after immuno-chemotherapy using multiple immunohistochemistry stains. The different infiltration levels of immune cells for TP53 and KRAS co-mutation were also explored using The Cancer Genome Atlas (TCGA) database and Cell type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT). To our knowledge, this is the first reported case in which a brain oligometastatic non-small cell lung carcinoma (NSCLC) patient has achieved a complete response after immuno-chemotherapy plus local surgical resection. | Source Title: | TRANSLATIONAL LUNG CANCER RESEARCH | URI: | https://scholarbank.nus.edu.sg/handle/10635/248954 | ISSN: | 2218-6751 2226-4477 |
DOI: | 10.21037/tlcr-21-380 |
Appears in Collections: | Staff Publications Elements |
Show full item record
Files in This Item:
File | Description | Size | Format | Access Settings | Version | |
---|---|---|---|---|---|---|
Complete disease remission in a iTP53i and iKRASi co-mutated brain oligometastatic lung cancer patient after immuno-chemothe.pdf | 0 B | Adobe PDF | CLOSED | None |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.