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Vol.61 No.5 contents | Japanese/English |
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- Case Report -
Favorable Response to an Immune Checkpoint Inhibitor in a Case of Non-small-cell Lung Cancer with Multiple Skeletal Muscle Metastases
Satoshi Hinata1, Kaoru Chiba1, Ken Okabayashi1, Hiromi Aono1, Yuko Asato1, Kazuyoshi Marumo11Department of Respiratory Medicine, Tokyo Metropolitan Police Hospital, Japan
Background. Most cases of non-small-cell lung cancer with skeletal muscle metastases show a poorer prognosis than those without skeletal muscle metastases. This is speculated to be partly due to the effect of epithelial-mesenchymal transition on tumor metastatic mechanisms. Although neither conventional chemotherapy nor radiotherapy has shown efficacy in cases of skeletal muscle metastases, little is known about the effectiveness of immune checkpoint inhibitors. Case. A 77-year-old man was injured in a motorbike accident, and he became aware of pain in his back and the back of his thighs and legs. The pain prevented him from remaining standing. We found a tumor shadow in his right hilar region on chest X-ray at the first visit. We diagnosed him with large-cell lung cancer with multiple metastases to the mediastinum and abdominal lymph nodes, liver, bilateral adrenal glands, skin, and muscles (cT4N3M1c Stage IVB according to the UICC TNM classification, 8th edition). Immunohistochemical staining was positive for vimentin, and the programmed cell death 1 ligand 1 tumor proportion score was 95%. Therefore, we started treatment with pembrolizumab as immune checkpoint therapy. By the end of the first course of this regimen, the primary tumor as well as the metastatic lesions had markedly contracted, and his performance status had improved. Conclusion. A favorable response was obtained using the immune checkpoint inhibitor pembrolizumab for the treatment of non-small-cell lung cancer with skeletal muscle metastases.
key words: Non-small-cell lung cancer, Multiple skeletal muscle metastases, Pembrolizumab, Epithelial-mesenchymal transition, Vimentin
Received: February 25, 2021
Accepted: May 7, 2021
JJLC 61 (5): 396-401, 2021
