Exceptional Regression of Malignant Pleural Mesothelioma with Pembrolizumab Monotherapy

The lead author with clinical stage I malignant pleural mesothelioma, epithelioid type, highly programmed cell death ligand 1 (PD-L1) positive, and BAP1 negative, experienced a prompt and exceptionally favorable response to pembrolizumab monotherapy. After cessation of treatment due to immune-relate...

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Bibliographic Details
Published in:Case reports in oncology 2020-12, Vol.13 (3), p.1483-1489
Main Authors: Hearon, Bernard F., Redelman, Kyle N., Elhomsy, Georges C., Moore, Jr, Dennis F.
Format: Article
Language:English
Subjects:
Antibodies
Apoptosis
Biomarkers
Case Report
Case reports
Cell death
Chemotherapy
Diabetes
Hypothyroidism
immune checkpoint inhibitor
Immune system
immune-related endocrinopathy
Immunotherapy
Labeling
Lymphocytes
malignant pleural mesothelioma regression
Medical imaging
Medical prognosis
Melanoma
Mesothelioma
Metabolism
Monoclonal antibodies
Patients
pembrolizumab monotherapy
programmed cell death ligand 1 expression
Radiation therapy
Response rates
Targeted cancer therapy
therapeutic biomarkers
Tomography
Tumors
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Summary:The lead author with clinical stage I malignant pleural mesothelioma, epithelioid type, highly programmed cell death ligand 1 (PD-L1) positive, and BAP1 negative, experienced a prompt and exceptionally favorable response to pembrolizumab monotherapy. After cessation of treatment due to immune-related endocrinopathies, complete metabolic response on interim PET/CT scan was achieved. Two years after initial diagnosis, unifocal tumor reactivation was addressed with successful pembrolizumab monotherapy rechallenge. Immunotherapy, typically not used as frontline treatment for malignant pleural mesothelioma, may provide an effective and durable response for some patients. Based on this single case study, epithelioid type tumors with strongly positive PD-L1 and BAP1-negative immunohistochemical markers may be well suited for treatment with immune checkpoint inhibitors such as pembrolizumab.
ISSN:1662-6575
1662-6575
DOI:10.1159/000512013