A Case of Advanced Squamous Cell Lung Cancer with Hemodialysis That Responded to Carboplatin and Nab-paclitaxel Combination Therapy After Progression on Pembrolizumab

Abstract

━━ Background. Patients with non-small cell lung cancer on hemodialysis have limited treatment options, and the prognosis is often severe because standard treatment cannot be administered. Case. A 70-year-old man with chronic kidney dysfunction was diagnosed with cT2aN1M0 stage IIB non-small cell lung cancer, and thoracoscopic left upper lobe resection was performed. One year later, recurrence due to liver metastasis was detected and pembrolizumab was administered as first-line therapy because the tumor showed a high PD-L1 expression level. Hemodialysis was introduced during treatment, and pembrolizumab treatment led to a partial response. After 11 courses of pembrolizumab, liver metastasis increased. The patient was subsequently treated with four courses of carboplatin and nab-paclitaxel as second-line therapy, which resulted in a partial response. Although blood transfusion was required for grade 3 anemia, the adverse events were manageable, end the patient was discharged from hospital. The third and fourth courses of treatment were continued as outpatient treatment. Conclusion. Combination chemotherapy with carboplatin and nab-paclitaxel after progression on pembrolizumab may be administered for patients with non-small cell lung cancer who are receiving hemodialysis, as it is efficient and tolerable.