The debatable role of immune checkpoint blockade therapy in lung adenocarcinoma-oriented liver metastatic malignant lesions.

Abstract

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.

• Authors: Dan Qiu, Hangtian Xi, Min Wang, Pengyu Jing, Zesheng Ren, Ning Chang, Wenrui Jiang, Xuemin Yang, Yan Zhang, Xiangxiang Chen, Yong Zhang, Jian Zhang
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 149 Issue 9 Pg. 5791-5802 (Aug 2023) ISSN: 1432-1335 [Electronic] Germany
• PMID: 36583744 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Immune Checkpoint Inhibitors
• B7-H1 Antigen

Topics

• Humans
• Carcinoma, Non-Small-Cell Lung (pathology)
• Lung Neoplasms (pathology)
• Immune Checkpoint Inhibitors (therapeutic use)
• Adenocarcinoma of Lung (drug therapy)
• Liver Neoplasms (drug therapy)
• B7-H1 Antigen