Lower dose pembrolizumab monotherapy in the treatment of brain metastases from non-small cell lung carcinoma : a report of 2 cases

Publication Date

2022

Document Type

Research

Abstract

This study reported 2 patients with lung cancer with brain metastasis upon diagnosis. The first patient is a 65-year-old male, non-smoker with PD-L1 expression of 60%. He was started on pembrolizumab 100 mg IV every 3 weeks and repeat CT scan after 11 cycles revealed reduction of the two brain metastatic lesions and no fluoro-D-glucose (FDG) uptake on positron emission tomography (PET) scan. The second patient is a 67-year-old female, previous smoker with PD-L1 expression of 50% with a metastatic solitary solid nodule in the cortex of the right cerebellum. After 3-4 cycles of pembrolizumab 100 mg IV every 3 weeks, there was noted complete resolution of brain metastasis on PET scan. Lower dose pembrolizumab (100 mg given every 3 weeks) was found to be effective in the management of advanced NSCLC with brain metastasis. Further studies should be done to investigate lower dose pembrolizumab as monotherapy without radiation therapy in patients with NSCLC with brain metastasis especially in the setting of a resource-limited country like the Philippines.

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