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Pembrolizumab plus platinum-based chemotherapy for unfavorable cancer of unknown primary site: Case report.

ABSTRACT: Introduction:We report a case of sustained complete response in unfavorable cancer of unknown primary site (CUP) successfully treated with chemotherapy combining pembrolizumab, pemetrexed and platinum. Case presentation:A 66-year-old man was presented with weight loss and cough for 3 months. Contrast-enhanced computed tomography (CT) confirmed a mass in the superior anterior mediastinum and multiple enlarged mediastinal and axillary lymph nodes. Positron emission tomography-CT (PET-CT) showed abnormal uptake in the corresponding lesions. Histopathological analysis of the left axillary nodule revealed poorly differentiated adenocarcinoma. Immunohistochemistry showed the tumor cells were positive for cytokeratin 7 and thyroid transcription factor-1 and negative for cytokeratin 20. Thus, the patient was diagnosed as poorly differentiated adenocarcinoma of unknown primary, and treated as non-small-cell lung cancer. Additional genetic testing revealed the patient was negative for EGFR, ALK fluorescence in situ hybridization, ROS1, BRAF, and PD-L1 22C3 IHC with Tumor Proportion Score (TPS) was less than 1%. The patient received six cycles of pembrolizumab, platinum, and pemetrexed intravenously. Cisplatin was switched to carboplatin because of cisplatin nephrotoxicity in one course. PET-CT after six cycles showed all lesions disappeared; complete response was considered to have been achieved. Maintenance therapy of pembrolizumab and pemetrexed has been continued for 6 months after the induction therapies to prevent progressive disease. Complete response has been maintained. Discussion:Chemotherapy with pembrolizumab, platinum and pemetrexed could be valuable for treating unfavorable CUP. Conclusion:Chemotherapy with pembrolizumab, platinum, and pemetrexed helped achieved sustained complete response in a patient with unfavorable CUP.

SUBMITTER: Kamada T

PROVIDER: S-EPMC7578551 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Pembrolizumab plus platinum-based chemotherapy for unfavorable cancer of unknown primary site: Case report.

Kamada Teppei T Ishiguro Hiroshi H Okada Shinya S Takeuchi Hideyuki H Takahashi Junji J Nakashima Keigo K Nakaseko Yuichi Y Suzuki Norihiko N Ohdaira Hironori H Suzuki Yutaka Y

Annals of medicine and surgery (2012) 20201017

<h4>Introduction</h4>We report a case of sustained complete response in unfavorable cancer of unknown primary site (CUP) successfully treated with chemotherapy combining pembrolizumab, pemetrexed and platinum.<h4>Case presentation</h4>A 66-year-old man was presented with weight loss and cough for 3 months. Contrast-enhanced computed tomography (CT) confirmed a mass in the superior anterior mediastinum and multiple enlarged mediastinal and axillary lymph nodes. Positron emission tomography-CT (PE ...[more]

PMID: 33101670

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Pembrolizumab plus platinum-based chemotherapy for unfavorable cancer of unknown primary site: Case report.

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Pembrolizumab plus platinum-based chemotherapy for unfavorable cancer of unknown primary site: Case report.

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