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A Case of End-stage non-small cell Lung Cancer Patient with Brain Metastasis Treated with Pembrolizumab with Integrative Medicine Therapy

Pembrolizumab과 통합의학치료로 호전된 뇌전이 동반 말기 비소세포성 폐암 환자 1례

  • Received : 2018.12.01
  • Accepted : 2018.12.18
  • Published : 2018.12.31

Abstract

Objective: The purpose of this study is to report the case of a patient with non-small cell lung cancer (NSCLC) with Programmed cell death protein 1 (PD-1) mutation treated by Integrative Medicine Therapy (IMT). Methods: A patient with metastatic NSCLC received pembrolizumab 200mg intravenously for every 3 weeks from July 2017. Repeat cycle every 3 weeks since July 2017. The patient has been treated with Integrative Medicine Therapy (IMT) since December 2016. The tumor size was measured by computed tomography (CT) and magnetic resonance imaging(MRI). Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After combined treatment, the extent of proximal portion of primary tumor in the left lower lobe was decreased and disease status was stable radiologically. No evidence of newly developed metastatic lesions in the brain since May 2017. The patient did not experience any adverse event according to NCI-CTCAE ver. 5.0. Conclusion: This case study suggests that Integrative Medicine Therapy (IMT) may contribute to tumor response, in conjunction with Pembrolizumab on the treatment of patients with NSCLC.

Keywords

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Figure 1a. Comparison of chest computed tomography

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Figure 1b. Comparison of chest computed tomography

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Figure 2. Comparison of brain magnetic resonance imaging

Table 1. Laboratory Findings

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References

  1. American Cancer Society: Cancer Facts & Figures 20OED. Atlanta: American Cancer Society; 2017 Available from :URL: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2018.html
  2. National Cancer Center, Annual report of cancer statistics in Korea in 2015, 2017 Available from :URL: http://ncc.re.kr/cancerStatsView.ncc?bbsnum=438&searchKey=total&searchValue=&pageNum=1
  3. R. Siegen, D. Naishadham, A. Jemal. Cancer statistics. CA: A Cancer Journal for Clinician 2012, 62(1):10-29 https://doi.org/10.3322/caac.20138
  4. Soda M, Choi YL, Enomoto M, Takada S, Yamashita Y, Ishikawa S, Fujiwara S, Watanabe H, Kurashina K, Hatanaka H, Bando M, Ohno S, Ishikawa Y, Aburatani H, Niki T, Sohara Y, Sugiyama Y, Mano H. Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. Nature 448:561-.566, 2007 https://doi.org/10.1038/nature05945
  5. Cancer Genome Atlas Research Network. Comprehensive molecular profiling of lung adenocarcinoma. Nature 511:543-550, 2014 https://doi.org/10.1038/nature13385
  6. Herbst RS, Baas P, Kim DW, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet 2016;387:1540-1550 https://doi.org/10.1016/S0140-6736(15)01281-7
  7. Health Insurance Review & Assessment Service. 암환자에게 처방.투여하는 약제에 대한 요양급여의 적용기준 및 방법에 관한 세부사항. 건강보험심사평가원 공고 제2018-295호, 2018.11.30. Available from : URL: https://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA030023010000&brdScnBltNo=4&brdBltNo=45563&pageIndex=1#none
  8. Martin Reck, Delvys Rodriguez-Abreu, Andrew G. Robinson, et al. Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. N Engl J Med 2016; 375:1823-1833 https://doi.org/10.1056/NEJMoa1606774
  9. Langer CJ, Gadgeel SM, Borghaei H, et al. Carboplatin and pemetrexed with or without pembrolizumab for advanced, non-squamous non-small-cell lung cancer: a randomised, phase 2 cohort of the open-label KEYNOTE-021 study. Lancet Oncol. 2016 Nov;17(11):1497-1508. doi: 10.1016/S1470-2045(16)30498-3. Epub 2016 Oct 10.
  10. Naidoo J, Page DB, Li BT, et al. Toxicities of the anti-PD-1 and anti-PD-L1 immune checkpoint antibodies. Annals of Oncology, 26(12), 2375-2391. doi: 10.1093/annonc/mdv383
  11. Hofmann L, Forschner A, Loquai C, et al. Cutaneous, gastrointestinal, hepatic, endocrine, and renal side-effects of anti-PD-1 therapy. Eur J Cancer. 2016 Jun;60:190-209. doi: 10.1016/j.ejca.2016.02.025. Epub 2016 Apr 13.
  12. Gaduet TW. Integrative medicine: the evolution of a new approach to medicine and to medical education. integrative medicine. 1998;1(2):67-73. https://doi.org/10.1016/S1096-2190(98)00028-6
  13. 김운용. 유방암 환자의 통합의료서비스 이용 예측 요인. 한양대학교 대학원 석사학위 논문. 2012
  14. 구광서. 재발전이암 환자의 통합의학 치료 경험. 한국방송통신대학교 대학원 석사학위 논문. 2016.
  15. 진용재. 항암치료와 통합 암치료 병용으로 호전된 전이성 난소 및 자궁 내막암 환자 1례. 대한암한의학회지. 2014; 19(1): 33-41. https://doi.org/10.15432/JKTO.2014.19.1.33
  16. 진용재. 항암치료와 통합 암치료 병용으로 호전된 전이성 난소 및 자궁 내막암 환자 1례. 대한암한의학회지. 2014; 19(1): 33-41. https://doi.org/10.15432/JKTO.2014.19.1.33
  17. Chen S, Flower A, Ritchie A, Liu J, Molassiotis A, Yu H, Lewith G. Oral Chinese herbal medicine (CHM) as an adjuvant treatment during chemotherapy for non-small cell lung cancer: A systematic review. Lung Cancer.68(2):137-145, 201 https://doi.org/10.1016/j.lungcan.2009.11.008
  18. 조종관, 면역에 관한 동양의학적 고찰, 동양의학, 12(1):19-23, 1986.
  19. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R. New response evaluation criteria in solid tumours: Revised RECIST guideline(version 1.1). Eur J Cancer 45: 228-247, 2009 https://doi.org/10.1016/j.ejca.2008.10.026
  20. National Cancer Institute. Common Terminology Criteria for Adverse Events(CTCAE) v.5.0, 2017. Available from https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_5.0/
  21. Ki-Rok Kwon, A-La Cho, Sun-Gu Lee, The Study on Acute and Subacute Toxicity and Anti-cancer. Journal of korean pharmacopuncture. 2003:6(2):7-27
  22. Chang-rak Im, Kang Kwon, Young Chan Sur, Sun-Hwi Bang, Seong Shin. A Case of Hepatic and Pulmonary Metastatic Colorectal Cancer Patient Treated by Traditional Korean Therapy and XELOX Chemotherapy. Journal of korea Traditional Oncology. 2012:17(1): 17 - 25. https://doi.org/10.15432/JKTO.2012.17.1.017
  23. Sun-Hwi Bang, Ki-rok Kwon, Hwa seung Yoo. Two Cases of Non-Small Cell Lung Cancer Treated with Intravenous Cultivated Wild Ginseng Pharma-copuncture. Journal of korean pharma-copuncture. 2008:11(2):13-19.
  24. 약침학 2판. 대한약침학회학술위원회.약침의학연구소. 229, 2011
  25. 임세영, 이수진, 권기록. 산삼약침이 Colon26-L5 암세포주를 이용한 간전이 모델의 항암 및 면역증진에 미치는 영향. 대한침구학회지 2006;23(1):133
  26. Toriyama-Baba H, Iigo M, Asamoto M, Iwahori Y, Park CB, Han BS, et al. Organotropic chemopreventive effects of n-3 unsaturated fatty acids in a rat multi-organ carcinogenesis model. Jpn J Cancer Res 2001;92(11):1175-83. https://doi.org/10.1111/j.1349-7006.2001.tb02137.x
  27. Petrovich Z, Stanley K, Cox JD, Paig C. Radiotherapy in the management of locally advanced lung cancer of all cell types: final reportof randomized trial. Cancer 1981;48:1335-40. https://doi.org/10.1002/1097-0142(19810915)48:6<1335::AID-CNCR2820480614>3.0.CO;2-S
  28. Chen YM. Update of epidermal growth factor receptortyrosine kinase inhibitors in non-small-cell lung cancer. J Chin Med Assoc 2013;76:249-57 https://doi.org/10.1016/j.jcma.2013.01.010
  29. 김동식, 조종관, 항암제로 활용되는 섬여 및 섬수에 관한 문헌적 고찰, 대전대학교한의학연구소논문집 4, 117-128, 1996
  30. 顔正華,王筠黙, 中葯現代硏究與應用(第5卷), p.5212-5231, 學苑出版社, 북경, 1997.
  31. Lee BW, Kim EH, Kim KW, Park HG. Fumigation Therapy and Aroma Therapy in Wai-Tai-Mi-Yao. Korea Institute of Science and Technology Information 18(3):116-125, 2005.
  32. Miyamoto K, Furusawa K, Kuroiwa A, Saito M, Miyata T, Furukawa T. Effects of qing-fei-tang on the airway inflammation and clearance. Am J Chin Med. 1990;18(1-2):5-18. https://doi.org/10.1142/S0192415X90000034
  33. 김동찬, 노승현, 이상인, 이영종, 주영승. 방제학. 서울:영림사. 1990:111-3,263-4.
  34. Fushinati S, Tsuchiya K, Minakuchi K, Takasugi M, Murakami K. Studies on attenuation of post-ischemic brain injury by Kamp medicines inhibitory effects of fress radical production. Journal of the Pharmaceutical Society of Japan. 1994;114(6):388-94. https://doi.org/10.1248/yakushi1947.114.6_388
  35. Mizukawa H, Yosshida K, Honmura A, Uchiyama Y, Kaku H, Nakajima S, Haruki E. The effect of Oren-gedoku-to on experimentally-inflamed rats. American Journal of Chines Medicine. 1993:21(1):71-8 https://doi.org/10.1142/S0192415X93000091
  36. 성현경.黃連解毒湯이 數種의 人間癌細胞增殖에 미치는 影響.동국대학교 석사학위논문.2010.
  37. 陳自明. 婦人良方校注補遺. 上海:上海科學技術出版社. 1991.
  38. Ohno T, Yanai M, Ando H, Toyomasu Y, Ogawa A, Morita H, et al. Rikkunshito, a traditional Japanese medicine, suppresses cisplatin-induced anorexia in humans. Clin Exp Gastroenterol. 2011;4:291-6.
  39. Fujitsuka N, Uezono Y. Rikkunshito, a ghrelin potentiator, ameliorates anorexia-cachexia syndrome. Front Pharmacol. 2014;10(5):271.
  40. McCormick WJ. Cancer: the preconditioning factor in pathogenesis; a new etiologic approach. Arch Pediatr 1954; 71 (10): 313-2.
  41. McCormick WJ. Ascorbic acid as a chemotherapeutic agent. Arch Pediatr 1952; 69 (4): 151.
  42. Sharif-Khatibi L, Kariminia A, Khoei S, Goliaei B. Hyperthermia induces differentiation without apoptosis in permissive temperatures in human erythroleukaemia cells. Int J Hyperthermia 2007 Dec;23(8):645-655. https://doi.org/10.1080/02656730701769833
  43. Rasi G, Silecchia G, Sinibaldi-Vallebona P(1994). Anti-tumor effect of combined treatment with thymosin alpha 1 and interleukin-2 after 5-fluorouracil in liver metastases from colorectal cancer in rats. International Jounal of Cancer 57:701-705 https://doi.org/10.1002/ijc.2910570516
  44. Mastino A, Favalli C, Grelli S(1992). Combonation therapy with thymosin alpha 1 potentiastes the antitumor activity of interleukin-2 with cyclophosphamide in the treatment of the Lewis Lung carcinoma in mice. International Journal of Cancer 50:493-499 https://doi.org/10.1002/ijc.2910500327
  45. van der Zee J. Heating the patient: a promising approach? Ann Oncol. 2002;13(8):1173-1184. https://doi.org/10.1093/annonc/mdf280
  46. Sharif-Khatibi L, Kariminia A, Khoei S, Goliaei B. Hyperthermia induces differentiation without apoptosis in permissive temperatures in human erythroleukaemia cells. Int J Hyperthermia 2007 Dec;23(8):645-655. https://doi.org/10.1080/02656730701769833
  47. Wust P, Hildebrandt B, Sreenivasa G, Rau B, Gellermann J, Riess H, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol 2002 Aug;3(8):487-497. https://doi.org/10.1016/S1470-2045(02)00818-5