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Negativation of PD-L1 Postoperatively in Initially Inoperable Stage III Non-Small Cell Lung Cancer Treated with Pembrolizumab: Two Case Reports

Authors
  • Nasr, Fadi
  • Al Ghoche, Ahmad
  • Eid, Roland
  • Nasr, Lewis
  • Diab, Saada
  • Hallit, Souheil
  • Riachi, Moussa
Type
Published Article
Journal
Case Reports in Oncology
Publisher
S. Karger AG
Publication Date
Jun 05, 2019
Volume
12
Issue
2
Pages
421–425
Identifiers
DOI: 10.1159/000500671
PMID: 31244645
PMCID: PMC6587214
Source
Karger
Keywords
License
Green
External links

Abstract

Stage III non-small cell lung cancer is a border line stage between localized and metastatic disease. PDL-1 is gaining an important role in the therapeutic arsenal of lung cancer, the most frequent cancer worldwide. We report for the first time a negativation of PDL-1 status in 2 cases of stage IIIA NSCLC with conversion to operable disease after using immunotherapy. The first patient was a 59-year old female diagnosed incidentally to have stage IIIA inoperable NSCLC that was treated with combination chemo-immunotherapy, and converted to operable disease with a negative PD-L1 in the postoperative setting. The second case is that of a 56-year old male that also had an inoperable stage IIIA NSCLC treated with chemotherapy first line followed by pembrolizumab at progression, then operated after surgical conversion, with negative PD-L1 postoperatively. In front of these findings, further work should be done to elucidate if the reverse of the PDL-1 status and the conversion to operability were due to the use of immunotherapy or to an incidental finding. If confirmed, it may have a therapeutic impact.

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