Non-small Cell Lung Cancer Treated by an Anti-programmed Cell Death-1 Antibody without a Flare-up of Preexisting Granulomatosis with Polyangiitis

Takahiro Yamada; Takeshi Masuda; Kakuhiro Yamaguchi; Shinjiro Sakamoto; Yasushi Horimasu; Shintaro Miyamoto; Taku Nakashima; Hiroshi Iwamoto; Shintaro Hirata; Kazunori Fujitaka; Hironobu Hamada; Eiji Sugiyama; Noboru Hattori

doi:10.2169/internalmedicine.3018-19

CASE REPORTS

Non-small Cell Lung Cancer Treated by an Anti-programmed Cell Death-1 Antibody without a Flare-up of Preexisting Granulomatosis with Polyangiitis

Takahiro Yamada, Takeshi Masuda, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yasushi Horimasu, Shintaro Miyamoto, Taku Nakashima, Hiroshi Iwamoto, Shintaro Hirata, Kazunori Fujitaka, Hironobu Hamada, Eiji Sugiyama, Noboru Hattori

Author information

Takahiro Yamada
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Takeshi Masuda
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Kakuhiro Yamaguchi
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Shinjiro Sakamoto
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Yasushi Horimasu
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Shintaro Miyamoto
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Taku Nakashima
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Hiroshi Iwamoto
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Shintaro Hirata
Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Japan
Kazunori Fujitaka
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Hironobu Hamada
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan
Eiji Sugiyama
Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Japan
Noboru Hattori
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan

Keywords: non-small cell lung cancer, anti-PD-1 antibody, pembrolizumab, granulomatosis with polyangiitis

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 21 Pages 3129-3132

DOI https://doi.org/10.2169/internalmedicine.3018-19

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Abstract

The safety and efficacy of anti-programmed cell death-1 (PD-1) antibodies in patients with granulomatosis with polyangiitis (GPA) still remain unclear. An 83-year-old man with GPA that was well controlled with immunosuppressive therapy was diagnosed with a postoperative recurrence of non-small cell lung cancer (NSCLC). Because the programmed cell death ligand 1 (PD-L1) tumor proportion score was 90%, pembrolizumab was administered. After 10 cycles, immune-related adverse events or GPA flare was not observed, and the patient showed an antitumor response. Anti-PD-1 antibody should therefore be considered a treatment option for PD-L1-high-expressing NSCLC patients with well-controlled GPA.

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