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Vol.58 No.4 contents | Japanese/English |
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- Case Report -
Complete Response of a Patient with Lung Squamous Cell Carcinoma After Only Three Administrations of Nivolumab
Sakae Fujimoto1, Atsushi Fujita2, Koichi Minato1, Misa Iijima31Department of Pulmonary Medicine, 2Department of Thoracic Surgery, 3Department of Clinical Pathology, Gunma Prefectural Cancer Center, Japan
Background. Nivolumab is a programmed death (PD)-1 antibody that activates T cells by inhibiting the binding of T cells expressing PD-1 to a tumor expressing PD-ligand 1 (PD-L1). However, since immunosuppressive cells are involved in in vivo tumor immunity, nivolumab-activated T cells are suppressed. Although achieving a complete response (CR) using only nivolumab as a single agent would be difficult from the viewpoint of tumor immunology, such CR cases have been reported recently. We herein report a patient with lung squamous cell carcinoma who achieved a CR following only three administrations of nivolumab. Case. An 80-year-old Japanese man was admitted to our hospital following a medical examination's abnormal results. Based on a further evaluation, he was diagnosed with lung squamous cell carcinoma of the left upper lobe (cT4N3M1a stage IV). He also had eosinophilia in the blood and eosinophil infiltration in the tumor tissue. He received docetaxel as first-line therapy for four cycles and S-1 as second-line therapy for three cycles. After further progressive disease, nivolumab (3 mg/kg every 2 weeks) was intravenously administered three times as a third-line therapy, but it was discontinued due to a thyroid hormone abnormality. Blood eosinophils rapidly increased after the first administration, and the primary lesion was cavitated at two months after the third administration. He achieved a CR with remaining scar tissue by five months after the third administration. There has been no recurrence of lung cancer, but the patient's blood eosinophilia persisted at 21 months after the third administration. Conclusion. Eosinophils may be involved in a tumor's immune response to nivolumab, since our patient achieved a CR and his blood eosinophils rapidly increased following only three administrations of nivolumab.
key words: Nivolumab, Immune checkpoint inhibitor, Complete response, Squamous cell carcinoma, Eosinophil
Received: April 19, 2018
Accepted: May 31, 2018
JJLC 58 (4): 292-297, 2018
