Atezolizumab for first-line treatment of advanced lung adenocarcinoma with high PD-L1 expression
Abstract
Introduction: Lung cancer is the leading cause of cancer death both worldwide and in Cuba. 85% correspond to the subtype non-small-cell lung carcinoma, among which adenocarcinoma represents 30-40%. More than 50% of the patients are diagnosed at an advanced stage. In cases of metastatic adenocarcinomas, the therapeutic option of choice is systemic treatment, which varies in keeping with the molecular characteristics of the tumor. In recent years, immunotherapy is the first-line therapeutic standard for metastatic patients with high PD-L1 expression (50%) and no point mutations.
Objective: Describe the first case of a patient diagnosed with advanced high PD-L1 expression lung adenocarcinoma treated with first-line atezolizumab.
Clinical case: A case is presented of a female 53-year-old patient diagnosed with right lung adenocarcinoma. Absence of EGFR, ALK and ROS-1 mutations was determined. Immunohistochemical testing identified high PD-L1 expression (CT3/CI1). Multidisciplinary consultation classified the tumor as stage IV and proposed treatment with the PD-L1 inhibitor atezolizumab every 21 days until progression or unacceptable toxicity. Complete response was achieved and the patient remains under treatment without any relevant toxicity.
Conclusions: In patients with advanced non-small-cell lung cancer and high PD-L1 expression, therapy with atezolizumab may achieve complete response and disease control.
Key words: PD-L1, atezolizumab, non-small-cell lung cancer, adenocarcinoma.
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