A 62-Year-Old Male With Stage III Non-Small Cell Lung Cancer
A 62-Year-Old Male With Stage III Non-Small Cell Lung Cancer
Case: A 62-Year-Old Male With Stage III NSCLC
Initial presentation
- A 62-year-old man presented with a 2-month history of cough, wheezing, and loss of appetite
- PMH: Hypertension, medically treated
- SH: 30 pack-year smoking history; daughter to be married in 11 months, and wants to attend the wedding
- PE: Right lower lobe wheezing on auscultation
Clinical workup
- Labs: WNL
- PFT: FEV1/FVC 60%; DLCO 55%
- Chest/abdomen/pelvic CT showed a 6.1-cm solid pulmonary lesion in the right lower lobe, right hilar and intrapulmonary lymph node involvement; no evidence of distant metastases
- PET scan showed large focal hypermetabolic activity in the right lower lobe and small hypermetabolic activity in the surrounding area
- Contrast‐enhanced MRI of the head showed no brain metastases
- Bronchoscopic biopsy of the RLL mass and hilar node revealed squamous NSCLC
- Staging: T3N1M0 IIIA; ECOG PS 1
- Unresectable NSCLC based on the extent and location of disease
Treatment
- Patient was started on cisplatin 50 mg/m2on days 1,8,29 and 36; etoposide 50 mg/m2days 1-5 and 29-33; concurrent RT
- No disease progression after chemoradiation
- Durvalumab 10mg/kg IV q2W was started and dose was tolerated well
- Initial follow-up at 2 months showed partial response, with shrinkage of primary and nodal lesions
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