title: Battling regional (stage III) lung cancer: bumpy road of a cancer survivor in the immunotherapy age.
abstract: A 58-year-old woman, a heavy smoker, was diagnosed with stage III squamous cell lung cancer. She was treated with concurrent chemotherapy and radiotherapy, with partial response. 2 months later, she had haemoptysis caused by brisk bleeding from the radiated right upper lobe. Fortunately, her bleed was self-limited. 4 months later, a rapidly enlarging renal mass was discovered and turned out to be metastatic from the lung primary. Second-line chemotherapy with docetaxel and ramucirumab did not have effects on the renal mass after 2 cycles. Despite not being eligible for a durvalumab trial because of lack of PD-L1 expression, she had a meaningful response to nivolumab. Once every 2 weeks, infusion of nivolumab resulted in rapid tumour shrinkage in multiple areas. In the next few months, she experienced a variety of side effects, some of which were potentially life-threatening. She had disease progression 9 months into treatment.
authors.affiliation: Department of Medicine, Cancer Center, Georgia Regents University, Medical College of Georgia, Augusta, Georgia, USA.
authors.forename: Zhonglin
authors.initials: Z
authors.lastname: Hao
authors.affiliation: Department of Pathology, Georgia Regents University, Augusta, Georgia, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Biddinger
authors.affiliation: Department of Surgery, Georgia Regents University, Augusta, Georgia, USA.
authors.forename: Carsten
authors.initials: C
authors.lastname: Schroeder
authors.affiliation: Department of Medicine, Georgia Regents University, Augusta, Georgia, USA.
authors.forename: Khurram
authors.initials: K
authors.lastname: Tariq
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008175:Lung Neoplasms / Q000473:pathology*; D008875:Middle Aged; D000077594:Nivolumab; D017741:Survivors
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000077594:Nivolumab