 |
Vol.57 No.7 contents | Japanese/English |
 | Full Text of PDF (3645K) Article in Japanese |
- Case Report -
A Good Response to Nivolumab in a Patient with Heavily Pre-treated KRAS Mutant Invasive Mucinous Adenocarcinoma
Ayumu Otsuki1, Kei Nakashima1, Masafumi Misawa1, Masahiro Aoshima11Department of Pulmonary Medicine, Kameda Medical Center, Japan
Background. Invasive mucinous adenocarcinoma (IMA) is an adenocarcinoma variant that shows a strong correlation with the KRAS mutation. In addition, IMA is often without an EGFR mutation and shows a poor tumor response to anticancer chemotherapy. Nivolumab is an immune checkpoint inhibitor that is specific for programmed death 1 and is reported to be effective in prolonging the overall survival in cases of KRAS mutation-positive non-small-cell lung cancer. We herein report a case of KRAS mutation-positive IMA with a good response to nivolumab. Case. A 60-year-old man was admitted to our hospital because of sputum. He was diagnosed with adenocarcinoma (cT3N0M0 stage IIB). A month later, he underwent right lower lobectomy. Two months later, he had tumor recurrence and was treated with a combination of carboplatin and pemetrexed for 6 cycles, followed by maintenance therapy with pemetrexed for 3 cycles. After disease progression, he received albumin-bound paclitaxel as second-line therapy for 12 cycles and docetaxel as third-line therapy for 2 cycles. After disease progression, a transbronchial lung biopsy was performed, which revealed KRAS mutation-positive IMA. The patient received nivolumab as fourth-line therapy. A partial response was maintained after receiving nivolumab for 14 cycles. Conclusion. Nivolumab may be an effective treatment for IMA after determining the KRAS mutation status.
key words: Invasive mucinous adenocarcinoma, KRAS mutation, Nivolumab
Received: July 14, 2017
Accepted: September 13, 2017
JJLC 57 (7): 843-848, 2017
