NSCLC (Non-Small Cell Lung Cancer) and kidney tumor in the elderly patient with response to chemoimmunotherapy
Abstract
Immune checkpoint inhibitors are standard of care for front-line metastatic NSCLC without activating mutations. In the Czech Republic, due to health insurance reimbursement it is possible to choose treatment with pembrolizumab monotherapy (squamous and nonsquamous NSCLC with PD-L1 expression >= 50 %) or combination of pembrolizumab and platinum-based chemotherapy (squamous NSCLC with PD-L1 expression 1-49 %, nonsquamous NSCLC with PD-L1 expression 1-100 %).
The efficacy of pembrolizumab plus chemotherapy for metastatic nonsquamous NSCLC was proved by KEYNOTE-189 trial. Pembrolizumab has a broad range of other indications (e. g. renal cell carcinoma, urothelial carcinoma, melanoma, Hodgkin lymphoma, head and neck squamous cell cancer).
It is the biological age of an individual rather than his chronological age which should determine the choice of a treatment. The case report describes the case of a 86-year-old patient.
He was diagnosed with metastatic nonsquamous NSCLC and right kidney tumor (based on radiography imaging). The patient is successfully treated, initially with a combination of pembrolizumab and chemotherapy, continuing with pembrolizumab monotherapy.