Endoscopic central airway recanalization to enable first line pembrolizumab treatment in a PD-L1 strongly positive non-small cell lung cancer: a ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Alfonso Fiorelli, Fabio Perrotta, Mariano Mollica, Mario Santini, Fabiana Vitiello, Marina Gilli, Cecilia Calabrese, Andrea Bianco

ABSTRACT

BACKGROUND: Tracheobronchial malignant stenosis is a life-threatening condition which may cause recurrent infections due to lung atelectasis. Despite immunotherapy is less toxic than standard chemotherapy, recurrent lung infections may represent a challenge for this treatment. We report a clinical case of a patient with metastatic squamous cell carcinoma suffering from pulmonary infections due to central airway obstruction who underwent endoscopic recanalization followed by immunotherapy. CASE PRESENTATION: A 64 year-old man was referred to our attention for the management of metastatic squamous cell carcinoma obstructing the right main bronchus with recurrent pulmonary infections. Patient exhibited strong positive PD-L1 expression (> 50%). Advanced disease stage contraindicated surgical treatment. Although therapy with immune check point inhibitors was indicated as first-line treatment, recurrent pulmonary infections made it unfeasible. Therefore, we planned a combined approach including endoscopic recanalization of central airway in order to resolve lung atelectasis, and lung infection followed by immunotherapy treatment with pembrolizumab in order to avoid local and systemic disease progression. CONCLUSIONS: At 16-week follow-up, the patient was alive in stable disease with improvement of clinical condition and no signs of lung infection. More... »

PAGES

50

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13019-019-0862-6

DOI

http://dx.doi.org/10.1186/s13019-019-0862-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112527687

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30832704


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