Successful treatment of a patient with non-small cell lung cancer and interstitial lung disease with durvalumab: a case report

Lung Cancer
10/07/2020

Tao H, et al. Ann Palliat Med 2020.

ABSTRACT

For patients with advanced non-small cell lung cancer (NSCLC), immune checkpoint inhibitors (ICIs) can offer an effective treatment. However, despite their potential benefits, the use of ICIs can lead to inflammation in various organs, including pneumonitis. Interstitial lung disease (ILD), which is a common complication in patients with NSCLC, can increase the risk of pneumonitis. For NSCLC patients with ILD, the safety of ICIs has yet to be established. Durvalumab is a selective,


high-affinity, engineered, human IgG1 monoclonal antibody, which showed durable response and manageable side effects in stage III NSCLC patients after definitive chemoradiotherapy. Pneumonitis in patients who received durvalumab was mostly low grade, given the potential applications in NSCLC with ILD. A 77-year-old man was diagnosed with Stage IV lung squamous carcinoma and ILD at our hospital. The PD-L1 expression assessed by VENTANA PD-L1 (SP263) Assay showed about 60% of tumor cells exhibit positive. Because the patient refused chemotherapy, he was given durvalumab at 20 mg/kg every 4 weeks as first-line anti-tumor therapy. After four cycles of therapy, the patient achieved partial remission, and complete remission(CR) had been achieved after 6 cycles of therapy and maintained over two years. No immune-related adverse events were reported. In this case, PD-L1 inhibitors were used to safely treat an NSCLC patient with ILD, which presents the need for further evaluation of their use.