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Published on: April 22, 2019
Case Report: Immune Checkpoint Inhibitors Successfully Controlled Asymptomatic Brain Metastasis in Esophageal
Linlin Xiao1, Chi Lin2, Yueping Liu3
1Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Background:
Brain metastases are the most common cause of intracranial malignancy, often resulting in significant morbidity and mortality. Brain metastases from esophageal squamous cell carcinoma (ESCC) are relatively rare, with a rate of generally less than 2%.
Case Report:
In this article, we report a rare case of ESCC with asymptomatic brain metastasis. The combined positive score (CPS) of programmed cell death-ligand 1 (PD-L1) from the primary tumor was 2 by DAKO 22C3 and 3 by VENTANA SP263. The proportion of tumor infiltrating lymphocytes (TILs) was 1%. After receiving 15 cycles of immune checkpoint inhibitors (ICIs), the patient's brain metastatic lesion had disappeared and was replaced by a local necrotic area. He retains good cognitive function with a stable disease at the primary site.
Conclusions:
This is the first to be reported in an ESCC patient whose brain metastatic lesion had a complete response to ICIs, which may provide supporting data for using ICIs as an option of treatment for ESCC patients with brain metastases.
Insights
This case study details a rare instance of esophageal squamous cell carcinoma (ESCC) with brain metastasis. Treatment with immune checkpoint inhibitors (ICIs) led to the complete disappearance of the brain lesion, suggesting a potential new therapeutic avenue.
Area of Science:
- Oncology
- Immunotherapy
- Neurology
Background:
- Brain metastases are a frequent cause of mortality in cancer patients.
- Metastasis to the brain from esophageal squamous cell carcinoma (ESCC) is uncommon, occurring in less than 2% of cases.
Observation:
- A rare case of ESCC with asymptomatic brain metastasis is presented.
- The patient's primary tumor showed a low combined positive score (CPS) for PD-L1 (2 by DAKO 22C3, 3 by VENTANA SP263) and 1% tumor-infiltrating lymphocytes (TILs).
Findings:
- Following 15 cycles of immune checkpoint inhibitors (ICIs), the patient experienced a complete response in the brain metastatic lesion, which became necrotic.
- The patient maintained good cognitive function and stable disease at the primary tumor site.
Implications:
- This is the first reported case of a complete response in brain metastases from ESCC using ICIs.
- The findings suggest that ICIs may be a viable treatment option for ESCC patients with brain metastases.
