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AbdelNasir Nourallah



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    EP1.01 - Advanced NSCLC (ID 150)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.01-96 - Metastatic Lymphoepithelial Lung Cancer (Now Available) (ID 244)

      08:00 - 18:00  |  Presenting Author(s): AbdelNasir Nourallah

      • Abstract
      • Slides

      Background

      NSCLC remains the leading cause of cancer deaths globally. Lymphoepithelial-like carcinoma (LELC) of the lung, (EBV)-driven tumor; mostly found in East Asian population; is not only one of the rarest subtypes of non-small cell lung cancer (NSCLC) but is also quaint to have a good prognosis. Advanced or metastatic Lymphoepithelial lung cancer is even rarer. LELC of the lung is traditionally considered be chemo-sensitive; although recurrences common lending to chemo-related toxicity and increased morbidity. High predilection of LELC for Programmed Death Ligand-1 (PDL-l) positivity and its long established association with EBV, led to the exploration of the role of PD- 1/PDL- 1 inhibitors in its management.

      Method

      poster / case report

      Result

      There have been only 4 cases reported in literature highlighting the use of PDL/PDL-1 inhibitors in LELC of lung and that too in recurrent/relapsed setting; out of which three had a favorable outcome and only one patient was treated with Pembrolizumab . We report the first case of a young Pilipino female who presented with metastatic LELC of the lung with vertebral metastases causing severe lower backache; initially treated with chemotherapy, followed by Pembrolizumab alone due to high PDL-I expression in her tumor, resulting in complete remission of symptoms and radiological evidence of complete metabolic resolution of multiple metastatic bony lesions. This case not only necessitates the need for larger prospective trials to assess the role or PD- 1/PDL- 1 inhibitors in this rare kind or lung cancer but also reiterates the long-brewing dilemma regarding the duration of treatment with these agents after achievement of complete remission.

      Conclusion

      Pembrolizumab used alone in high PDL-I expression, results in complete remission of symptoms and radiological evidence of complete metabolic resolution of multiple metastatic bony lesions in patients with NCSLC Lymphoepithelial-like carcinoma (LELC)

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