2023 World Conference on Lung Cancer (Posters)-EP11.03. Successful Treatment with Pembrolizumab Alone for SMARCA4-deficient Lung Sarcomatoid with a High-TMB and PD-L1(+) A Case Report

EP11.03. Successful Treatment with Pembrolizumab Alone for SMARCA4-deficient Lung Sarcomatoid with a High-TMB and PD-L1(+) A Case Report - PDF(Slides)

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This case report discusses the successful treatment of a patient with SMARCA4-deficient lung sarcomatoid using pembrolizumab, an immune checkpoint inhibitor. SMARCA4 is a subunit of the chromatin-remodeling complex and its deficiency has been associated with non-small cell lung cancer (NSCLC) characterized by a carcinoma or sarcomatoid phenotype. However, effective treatments for this type of NSCLC have not yet been established. <br /><br />The patient in this case was a 71-year-old man with a history of smoking but no family history of cancer. Imaging showed a primary tumor in the right upper lobe and metastatic lymph nodes. Biopsy and genetic sequencing revealed SMARCA4 deficiency and a high tumor mutation burden (TMB). PD-L1 expression was positive.<br /><br />The patient opted to receive pembrolizumab as first-line treatment instead of chemotherapy. After two doses, a significant reduction in the primary tumor and metastatic lymph nodes was observed. Follow-up imaging showed continuous lesion shrinkage, leading to a partial response. The disease has been under control for more than 12 months.<br /><br />The authors conclude that pembrolizumab alone may be a promising treatment strategy for advanced patients with SMARCA4-deficient lung sarcomatoid. This case highlights the potential efficacy of immune checkpoint inhibitors in this specific subtype of NSCLC. However, further research is needed to confirm these findings and determine optimal treatment approaches.<br /><br />Overall, this case report adds to the understanding of targeted therapies for NSCLC and highlights the potential benefit of using immunotherapy in patients with SMARCA4-deficient lung sarcomatoid.

Asset Subtitle

Youjun Deng

Meta Tag

Speaker Youjun Deng

Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

SMARCA4-deficient lung sarcomatoid

pembrolizumab

immune checkpoint inhibitor

non-small cell lung cancer

NSCLC

carcinoma

sarcomatoid phenotype

treatment

targeted therapies

immunotherapy