Pembrolizumab for choroidal metastases from non-small cell lung cancer: a case report and literature review

Li, Xinsheng; Yue, Liang; Wang, Jingfan; Hu, Zizhong; Yuan, Zhilan; Xie, Ping

doi:10.1080/21645515.2021.1885282

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…Nevertheless, non‐small cell lung cancers with EGFR exon 20 insertion mutations have been indicated to be poorly responsive to EGFR‐targeted agents 7,8 . On the other hand, as for immune checkpoint inhibitors, a case of lung cancer with choroidal metastases treated with pembrolizumab plus chemotherapy has been reported 9 . However, the case treated with nivolumab plus ipilimumab plus two cycles of chemotherapy has not been reported.…”

Section: Discussionmentioning

confidence: 99%

“… 7 , 8 On the other hand, as for immune checkpoint inhibitors, a case of lung cancer with choroidal metastases treated with pembrolizumab plus chemotherapy has been reported. 9 However, the case treated with nivolumab plus ipilimumab plus two cycles of chemotherapy has not been reported. The combination of systemic chemotherapy with immune checkpoint inhibitors might be an option for lung cancer patients with choroidal metastasis who have no treatable driver genes including EGFR exon 20 insertion mutations, because it is expected to not only prolong OS but also improve ocular symptoms caused by choroidal metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Improving visual acuity with nivolumab plus ipilimumab plus two cycles of chemotherapy following a diagnosis of lung adenocarcinoma with choroidal metastasis: A case report and literature review

Matsuyama,

Oniwa,

Tsuruzono

et al. 2023

Respirology Case Reports

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A 75‐year‐old woman presented at our hospital with bilateral visual impairment. Ophthalmological examination revealed multiple choroidal tumours. Chest computed tomography revealed a tumour shadow in the right lower lobe and multiple lymph node metastases in the mediastinum and pulmonary hilum. Following a detailed examination, the patient was diagnosed with primary lung adenocarcinoma (cT1cN3M1c Stage IVB) with choroid metastases. The tumour proportion score of programmed death ligand 1 (PD‐L1) was 1% and EGFR exon 20 insertion mutations were also detected. The patient was administered combination chemotherapy with nivolumab and ipilimumab. Primary lung and metastatic tumours, including the choroid, were reduced, and visual disturbances improved completely. Herein, we describe a rare case in which a combination of chemotherapy with nivolumab and ipilimumab significantly reduced vision loss due to choroidal metastasis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improving visual acuity with nivolumab plus ipilimumab plus two cycles of chemotherapy following a diagnosis of lung adenocarcinoma with choroidal metastasis: A case report and literature review

Matsuyama,

Oniwa,

Tsuruzono

et al. 2023

Respirology Case Reports

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“…There are very few clinical data reporting the effectiveness of immunotherapy on ocular metastases in the literature. In a recent case report, a favorable response of choroidal metastases was described in a non-small cell lung cancer with checkpoint inhibitor pembrolizumab, in association with pemetrexed and capecitabine [ 29 ]. In addition, responses of extra-ocular metastatic sites to immunotherapy are often limited.…”

Section: Treatment Optionsmentioning

confidence: 99%

How to Manage a Patient with Ocular Metastases?

et al. 2022

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Ocular metastases are the most frequent ocular malignant tumors; their prevalence is estimated around 5–10% and is even higher in patients with breast or lung cancer. They represent various clinical situations, but they share the same hierarchical multidisciplinary therapeutic challenge with respect to the way systemic and local therapies should be selected in combination or sequentially in the personalized medical history of a patient. The challenges include tumor control, eye preservation, and the minimization of iatrogenic damage to sensitive tissues surrounding the tumor in order to preserve vision. These aims should further contribute to maintaining quality of life in patients with metastases. Many patients with choroidal metastases have systemic molecular treatment for their primary tumor. However, secondary resistance to systemic treatment is common and may ultimately be associated with cancer relapse, even after an initial response. Therefore, it makes sense to propose local treatment concomitantly or after systemic therapy to provide a more sustainable response. The aim of this review is to present current therapeutic strategies in ocular metastases and discuss how to tailor the treatment to a specific patient.

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