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A Rare Delayed Atypical Pseudoprogression in Nivolumab-Treated Non-Small-Cell Lung Cancer
Suyanto Suyanto1, Daniel Yeo1, Sarah Khan1
1Nottingham University Hospital NHS Trust, UK.
Case Reports in Oncological Medicine
|April 5, 2019
Summary
Nivolumab can cause pseudoprogression, a condition where tumors appear to grow but are actually necrotic. This case highlights pseudoprogression occurring late in treatment for metastatic lung adenocarcinoma.
Area of Science:
- Oncology
- Immunotherapy
Background:
- Immune checkpoint inhibitors like Nivolumab enhance T-cell activity against tumors.
- Nivolumab is used for metastatic lung adenocarcinoma after chemotherapy failure.
Observation:
- A patient receiving Nivolumab showed initial tumor shrinkage, followed by apparent growth of a primary tumor.
- Biopsy revealed necrosis and inflammation, not active cancer, in the enlarged lesion.
- Further treatment confirmed regression in both primary and metastatic sites.
Findings:
- The patient experienced pseudoprogression, characterized by apparent tumor growth due to inflammatory changes.
- This pseudoprogression was observed late in the treatment course, after 15 cycles of Nivolumab.
Implications:
- Recognizing pseudoprogression is crucial for appropriate treatment management in patients receiving Nivolumab.
- This case expands the understanding of pseudoprogression timing and presentation in lung cancer.
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