A case of pulmonary adenocarcinoma showing rapid progression of peritoneal dissemination after immune checkpoint inhibitor therapy

Taro Shinozaki, Eri Iwami, Shinnosuke Ikemura, Tatsu Matsuzaki, Takahiro Nakajima, Kazuhiko Hashimoto, Takeshi Terashima

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Immune checkpoint inhibitors are standard treatments for non-small cell lung cancer. Unique cases with paradoxical acceleration of the disease after immunotherapy have been reported. These have been described as cases of hyperprogressive disease. Case presentation: A 76-year-old man was diagnosed with pulmonary adenocarcinoma with pleural dissemination and liver and adrenal metastases. Genomic analysis revealed neither EGFR mutations nor ALK translocations. Immunohistochemical analysis revealed a programmed death-ligand 1 tumor proportion score of 23%. Chemotherapy with carboplatin, paclitaxel, and bevacizumab resulted in Grade 3 skin eruption and disease progression. Pembrolizumab was initiated as a second-line treatment. However, peritoneal dissemination and ascites developed. The patient died 2weeks later. The autopsy revealed widespread peritoneal dissemination and an extensive hemorrhagic infarction. Conclusion: This was a rare case of hyperprogressive disease with rapid progression of peritoneal dissemination after pembrolizumab treatment.

Original languageEnglish
Article number620
JournalBMC Cancer
Volume18
Issue number1
DOIs
Publication statusPublished - 2018 May 31
Externally publishedYes

Keywords

  • Adenocarcinoma
  • Hyperprogressive disease
  • Immune checkpoint inhibitor
  • Lung cancer
  • Pembrolizumab
  • Peritoneal dissemination

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

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