Search

Programmed cell death‐1 immune checkpoint inhibitor (ICI) antibody has proven to be effective in advanced non‐small cell lung cancer (NSCLC) patients positive for programmed cell death‐1 ligand‐1. However, there are currently no reports which evaluate drug efficacy by continuous bronchoscopic observation. A 75‐year‐old man with complete right atelectasis was diagnosed with squamous cell carcinoma (SCC) of the right lower lobe (tumor proportion score: TPS 90%, cT4N3M0, stage 3C). For first‐line chemotherapy, carboplatin and nab‐paclitaxel were effective for the primary lesion and the right lung atelectasis improved. However, due to repeated febrile neutropenia with pneumonia, treatment was modified to pembrolizumab monotherapy. Bronchoscopic rebiopsy prior to second‐line treatment revealed high TPS, with a severe stenosis in the right main bronchus. After three courses of pembrolizumab, the right main bronchus opened completely, and no signs of malignancy were observed. Bronchoscopic narrow‐band and autofluorescence imaging also confirmed a complete endobronchial response. Subsequent bronchoscopic observation two years after the initial diagnosis showed a complete and continued response to treatment. ICIs can result in a drastic bronchoscopic response. In this case, the healing process was notable with minimal scarring, and resulted in continued locally bronchoscopic and complete pathological response to treatment compared to previous cytotoxic chemotherapy.

Programmed cell death‐1 immune checkpoint inhibitor (ICI) antibody has proven to be effective in advanced non‐small cell lung cancer (NSCLC) patients positive for programmed cell death‐1 ligand‐1. However, there are currently no reports which evaluate drug efficacy by continuous bronchoscopic observation. A 75‐year‐old man with complete right atelectasis was diagnosed with squamous cell carcinoma (SCC) of the right lower lobe (tumor proportion score: TPS 90%, cT4N3M0, stage 3C). For first‐line chemotherapy, carboplatin and nab‐paclitaxel were effective for the primary lesion and the right lung atelectasis improved. However, due to repeated febrile neutropenia with pneumonia, treatment was modified to pembrolizumab monotherapy. Bronchoscopic rebiopsy prior to second‐line treatment revealed high TPS, with a severe stenosis in the right main bronchus. After three courses of pembrolizumab, the right main bronchus opened completely, and no signs of malignancy were observed. Bronchoscopic narrow‐band and autofluorescence imaging also confirmed a complete endobronchial response. Subsequent bronchoscopic observation two years after the initial diagnosis showed a complete and continued response to treatment. ICIs can result in a drastic bronchoscopic response. In this case, the healing process was notable with minimal scarring, and resulted in continued locally bronchoscopic and complete pathological response to treatment compared to previous cytotoxic chemotherapy. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the utility of metallic stents for treating central airway stenosis caused by malignant tumors. The subjects were 72 patients (16 women, 56 men; mean age, 61 years; age range, 28-87 years) treated with metallic stents for dyspnea due to tracheobronchial stenotic lesions caused by malignant tumors between May 1990 and August 2010. The underlying disorder was primary lung cancer in 42 patients, metastatic lung cancer in 29, and mediastinal tumor in one patient. In 69 of 72 patients (95.8%), dyspnea began to improve following completion of the procedure. The average Hugh-Jones classification score improved from 4.2 before stenting to 2.8 after stenting. The patients' average survival following stent placement was 3.6 months (two days-33 months). Thirteen lesions developed re-obstruction during follow-up. Of these 13 lesions, eight patients with dyspnea underwent re-interventions with metallic stent replacement and improved. Airway stent placement is an immediate and effective method of treatment for dyspnea caused by stenotic lesions of the central airway due to malignant tumor. It is effective for treating stenosis due to either tracheobronchial intraluminal tumor or extrinsic compression. Restenting is also useful to treat dyspnea caused by restenosis following stent placement. [ABSTRACT FROM AUTHOR]