Whole-brain Radiation and Pembrolizumab Treatment for a Non-small-cell Lung Cancer Patient with Meningeal Carcinomatosis Lacking Driver Oncogenes Led to a Long-term Survival

Koki Nakashima; Yoshiki Demura; Masahiro Oi; Mio Tabata; Toshihiko Tada; Kohei Shiozaki; Masaya Akai; Tamotsu Ishizuka

doi:10.2169/internalmedicine.4232-19

CASE REPORTS

Whole-brain Radiation and Pembrolizumab Treatment for a Non-small-cell Lung Cancer Patient with Meningeal Carcinomatosis Lacking Driver Oncogenes Led to a Long-term Survival

Koki Nakashima, Yoshiki Demura, Masahiro Oi, Mio Tabata, Toshihiko Tada, Kohei Shiozaki, Masaya Akai, Tamotsu Ishizuka

Author information

Koki Nakashima
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan
Yoshiki Demura
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan
Masahiro Oi
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan
Mio Tabata
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan
Toshihiko Tada
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan
Kohei Shiozaki
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan
Masaya Akai
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan
Tamotsu Ishizuka
Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan

Keywords: non-small-cell lung cancer, meningeal carcinomatosis, immune checkpoint inhibitor, Pembrolizumab, whole-brain radiation therapy

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 11 Pages 1433-1435

DOI https://doi.org/10.2169/internalmedicine.4232-19

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Abstract

We herein report a 66-year-old woman with advanced lung adenocarcinoma [programmed cell death and its ligand 1 (PD-L1) tumor proportion score 60%] lacking driver oncogenes in whom meningeal carcinomatosis, along with sudden onset dizziness, deafness, and consciousness disturbance, appeared after second-line chemotherapy. Whole-brain radiation therapy (WBRT) and Pembrolizumab were subsequently administered, and third-line chemotherapy with Pembrolizumab is now ongoing. At the time of writing, the patient has achieved a 23-month survival without disease progression. Our findings suggest that the combination of WBRT and an immune checkpoint inhibitor is effective for non-small-cell lung cancer patients lacking driver oncogenes who develop meningeal carcinomatosis.

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