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Marta Nassif Pereira-Lima



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    P3.CR - Case Reports (Not CME Accredited Session) (ID 984)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.CR-18 - Central Nervous System Activity of Checkpoint Inihibitor in Non-Small-Cell Lung Cancer (ID 14148)

      12:00 - 13:30  |  Presenting Author(s): Marta Nassif Pereira-Lima

      • Abstract
      • Slides

      Background

      Data regarding the activity of atezolizumab in the central nervous system (CNS) and its toxicity in combination with radiotherapy in patients with brain metastases (BM) of non-small cell lung cancer (NSCLC) is limited. Most clinical trials adopt strict selection criteria excluding patients with active BM and the blood–brain barrier (BBB) seems responsible for limiting the distribution of agents into the CNS.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Here we present a 51 yr-old female patient with the diagnosis of stage IV NSCLC with an isolated BM (T3 N3 M1b, non-mutated EGFR). She received stereotactic radiosurgery (SRS) to the isolated brain lesion (figure 1) and sequential palliative first-line systemic monotherapy with atezolizumab (1200mg/dose q21d, 15 doses).

      figura 1.jpg

      4c3880bb027f159e801041b1021e88e8 Result

      Control brain MRI 3-month post SRS showed a new lesion in the thalamus (figure 2) while on atezolizumab. Medical team decided to continue systemic treatment and the repeat brain MRI demonstrated complete response to the new lesion. Additionally, treated lesion showed evidence of pseudoprogression. While on follow-up, the patient continued to respond in the brain for 14 months.

      figura 2.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      This case reports activity of atezolizumab in CNS. The advent of immunotherapy in the therapeutic algorithm of NSCLC has raised the need to identify patients that could mostly benefit from checkpoint inhibitors.

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