Extended survival with pembrolizumab in a patient with stage IV non-small cell lung cancer

A case report.

Abstract

Introduction: Immunotherapy with pembrolizumab has improved the prognosis of metastatic lung cancer. In the present case, a specific patient's extended survival and evolution is presented.

Clinical case: 66-year-old man, smoker. Diagnosed with a lung mass in the left lower lobe measuring 9 x 8 cm, with supra and infratentorial intra-axial metastases.

Diagnostic workshop: Established as a stage IVc lung neoplasm, the PDL1 status was confirmed to be positive in 80% of the lung mass sample. It debuts with pulmonary infections associated with a gram-negative bacillus Hafnia Alvei.

Evolution: Cephalosporins and immunotherapy treatment with Pembrolizumab were started, which was maintained for 33 months until the presence of a secondary effect attributed to pembrolizumab, completing 35 months of survival until the closure of this observation; the patient's death was not reported.

Conclusions: In the present report, the determination of the positive histological biomarker PDL1 in lung cancer helped prescribe treatment with targeted immunotherapy, which was shown to increase survival beyond conventional treatment with chemotherapy. In the present case, timely treatment of pulmonary bacterial infections and the study of tuberculosis also contributed to prolonged survival.