Achieving complete metabolic response in stage IV lung adenocarcinoma with chemotherapy, nivolumab, ipilimumab, and salvage SBRT: A case report

Abstract

Abstract Oncogene‐negative, PDL1‐negative metastatic non‐small cell lung cancer (NSCLC) presents significant treatment challenges due to its complexity and resistance to conventional therapies. The case report presented addresses a 55‐year‐old male patient with oncogene‐negative, PDL1‐negative stage IV lung adenocarcinoma, showcasing an exceptional complete metabolic response to a multimodality treatment combining double immune checkpoint inhibition (ICI) and chemotherapy, followed by salvage stereotactic body radiotherapy (SBRT). The patient underwent a treatment regimen incorporating two cycles of carboplatin, pemetrexed, nivolumab, and ipilimumab followed by nivolumab, and ipilimumab maintenance. After a partial response, SBRT was applied to persistent lesions, achieving a complete metabolic response. This case highlights the potential of combining dual ICI with chemotherapy and SBRT in treating oncogene‐negative, PDL1‐negative NSCLC underscoring the importance of multimodality treatment strategies.

Keywords

• adenocarcinoma
• dual checkpoint inhibition
• immunotherapy
• lung cancer
• metastatic