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Orthotopic Transplantation of Syngeneic Lung Adenocarcinoma Cells to Study PD-L1 Expression
Published on: January 19, 2019
The debatable role of immune checkpoint blockade therapy in lung adenocarcinoma-oriented liver metastatic malignant
Dan Qiu1, Hangtian Xi1, Min Wang1
1Department of Pulmonary and Critical Care of Medicine, The First Affiliated Hospital of the Air Force Military Medical University, #169 West Changle Road, Xi'an, 710032, ShaanXi Province, China.
Background:
The use of anti-PD-1 or PD-L1 inhibitors in combination with other anti-cancer agents was a priority for treating advanced non-small cell lung cancer (NSCLC) patients with considerable PD-L1 expression. However, studies seldom show the progression of liver metastases after using immune checkpoint inhibitors (ICIs).
Methods:
Data were obtained from the Department of Pulmonary and Critical Care of Medicine, the First Affiliated Hospital of the Air Force Military Medical University. In the present study, we analyzed five non-small cell lung cancer (NSCLC) patients who had liver metastases after they were treated with pembrolizumab between 2019 and 2021. All of them had both stable primary lesions and liver progression with pembrolizumab intervention. Blood laboratory tests and imaging examinations were performed regularly during the treatment to assess the tumor responses of patients.
Results:
All patients displayed reduction or stability in the initial lesions as a result, but they also experienced the emergence of metastatic liver locations, which were regularly detected throughout immunotherapy. Additionally, the appearance of liver metastasis weakened their liver function gradually with the escalation of carcinoembryonic antigen, regarded as a predictor for evaluating the progression of tumors. These individuals were highly distinctive with hyper-progressive diseases associated with immunotherapy. We drew individualized intervention schemes for metastatic lesions in each patient and found that their life expectancy shared no significance given the restricting subjected population.
Conclusions:
Our study indicated a clinical phenomenon after using immune checkpoint inhibitors and presented a necessity for implementing large scales clinical studies to manage NSCLC-oriented liver metastasis.
Insights
Advanced non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs) can develop liver metastases despite stable primary tumors. This study highlights the need for further research into managing this specific progression during immunotherapy.
Area of Science:
- Oncology
- Immunotherapy
- Medical Research
Background:
- Immune checkpoint inhibitors (ICIs) like anti-PD-1/PD-L1 agents are prioritized for advanced non-small cell lung cancer (NSCLC) with high PD-L1 expression.
- Limited data exists on the progression of liver metastases in NSCLC patients undergoing ICI therapy.
Purpose of the Study:
- To investigate the clinical phenomenon of liver metastasis development in NSCLC patients treated with pembrolizumab.
- To describe the characteristics and outcomes of NSCLC patients experiencing liver progression during immunotherapy.
Main Methods:
- Retrospective analysis of five NSCLC patients with liver metastases treated with pembrolizumab (2019-2021).
- Patients had stable primary lesions but progressive liver disease under pembrolizumab.
- Regular blood tests and imaging were used to monitor tumor response and liver function.
Main Results:
- All patients showed stable or reduced primary tumors but developed new or progressing liver metastases during immunotherapy.
- Emerging liver metastasis correlated with declining liver function and rising carcinoembryonic antigen levels.
- These cases exhibited hyperprogressive disease patterns associated with immunotherapy.
Conclusions:
- The study identified a distinct clinical pattern of liver metastasis progression in NSCLC patients receiving ICIs.
- There is a critical need for large-scale clinical studies to develop effective management strategies for ICI-induced liver metastasis in NSCLC.
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