Dramatic treatment response to immunotherapy after symptomatic pseudoprogression in patient with non small-cell lung cancer: a case report and review of the literature

Abstract

Background. Uncommon responses during immunotherapy is a new challenging issue in oncology practice. Recently, new criteria for evaluation of response to immunotherapy iRECIST were accepted. According to iRECIST, worsening of performance status (PS) accompanied to pseudoprogression reflects most probably the true progression of the malignant disease.

Case presentation. We present patient with symptomatic pseudoprogression after one application of anti PD-L1 therapy in a patient with metastatic NSCLC followed by dramatic treatment response to immunotherapy.

Methods. A systematic review of the English literature was made by using several electronic database with the following search criteria: symptomatic pseudoprogression, atypical response, immunotherapy and lung cancer.

Conclusion. As seen from our review, iRECIST criteria might be insufficient in distinguishing true progression from pseudoprogression in some patients with advanced NSCLC treated with immunotherapy. More precise assessment methods are urgently needed.