Takamasa Nakasuka1, Kadoaki Ohashi2, Hiromi Watanabe1, Toshio Kubo3, Shingo Matsumoto4, Koichi Goto4, Katsuyuki Hotta5, Yoshinobu Maeda1, Katsuyuki Kiura6. 1. Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan. 2. Department of Respiratory Medicine, Okayama University Hospital, Okayama, 700-8558, Japan. Electronic address: kohashi@cc.okayama-u.ac.jp. 3. Center for Clinical Oncology, Okayama University Hospital, Okayama, 700-8558, Japan. 4. Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, 277-8577, Japan. 5. Department of Respiratory Medicine, Okayama University Hospital, Okayama, 700-8558, Japan; Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, 700-8558, Japan. 6. Department of Respiratory Medicine, Okayama University Hospital, Okayama, 700-8558, Japan.
Abstract
OBJECTIVES: Pembrolizumab is a standard treatment for non-small cell lung cancer (NSCLC) with high-PD-L1 expression; however, its effect is dismal in patients with poor physical condition. Additionally, the effect of immunotherapy is generally limited in NSCLC harboring driver mutations such asEGFR, ALK, or RET gene aberrations. RESULTS: We report the beneficial effect of pembrolizumab in a patient with poor performance status and PD-L1+ lung adenocarcinoma with theCCDC6-RET fusion gene and co-occurring NF1/TP53 mutations, complicated by multiple cancer-associated thrombi and respiratory failure. CONCLUSIONS: Further studies are warranted to establish the role of co-occurring NF1/TP53 mutations as a positive predictive biomarker for pembrolizumab in NSCLC harboring RET fusion genes.
OBJECTIVES:Pembrolizumab is a standard treatment for non-small cell lung cancer (NSCLC) with high-PD-L1 expression; however, its effect is dismal in patients with poor physical condition. Additionally, the effect of immunotherapy is generally limited in NSCLC harboring driver mutations such asEGFR, ALK, or RET gene aberrations. RESULTS: We report the beneficial effect of pembrolizumab in a patient with poor performance status and PD-L1+ lung adenocarcinoma with theCCDC6-RET fusion gene and co-occurring NF1/TP53 mutations, complicated by multiple cancer-associated thrombi and respiratory failure. CONCLUSIONS: Further studies are warranted to establish the role of co-occurring NF1/TP53 mutations as a positive predictive biomarker for pembrolizumab in NSCLC harboring RET fusion genes.