DOI: 10.1097/md.0000000000049957 ISSN: 0025-7974

Combination of PD-1 inhibitor and chemotherapy for subcutaneous soft-tissue metastasis in postoperative non-small cell lung cancer

Qiang Zeng, Bin Yang, Yang Hu, Yuan Zeng

Rationale:

Despite available therapies, patients with advanced non-small cell lung cancer have a poor prognosis, highlighting the need for novel treatment strategies. The combination of immune checkpoint inhibitors and chemotherapy represents a promising approach. This case report describes the efficacy and safety of this combination in a patient with aggressive metastatic disease.

Patient concerns:

A 60-year-old male patient, who had undergone surgical resection for primary lung adenocarcinoma, presented with newly developed subcutaneous nodules and symptoms suggestive of adrenal involvement during routine follow-up.

Diagnoses:

Histopathological and imaging examinations confirmed recurrent lung adenocarcinoma with metastases to the subcutaneous soft tissues and the adrenal gland.

Interventions:

The patient received platinum-based doublet chemotherapy combined with pembrolizumab (an anti-programmed cell death protein 1inhibitor) as second-line systemic therapy.

Outcomes:

Following several treatment cycles, imaging revealed marked regression of metastatic lesions, with only minimal treatment-related adverse events reported. The patient achieved a durable clinical response.

Lessons:

This case suggests that combining chemotherapy with programmed cell death protein 1 inhibition may provide rapid and effective tumor control in advanced non-small cell lung cancer patients with bulky, symptomatic metastases, while maintaining a manageable safety profile. Further clinical trials are warranted to validate this approach.

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