PMID- 36701715
OWN - NLM
STAT- MEDLINE
DCOM- 20230130
LR  - 20230306
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 3
DP  - 2023 Jan 20
TI  - A lung squamous cell carcinoma-associated membranous nephropathy patient free of 
      tumor and membranous nephropathy after the treatment of surgery and 
      radiochemotherapy following pembrolizumab: A rare case report.
PG  - e32508
LID - 10.1097/MD.0000000000032508 [doi]
LID - e32508
AB  - RATIONALE: Membranous nephropathy (MN) is an autoimmune disease, which is 
      classified into primary and secondary MN. Malignancy-associated MN (M-MN) 
      accounts for about 10% of secondary MN cases. Lung cancer is the most common type 
      of malignancy among M-MN patients. Immune checkpoint inhibitors (ICIs) targeting 
      programmed cell death-1 (PD-1) or programmed cell death ligand-1 (PD-L1) have 
      showed promising efficacy and good safety in many types of solid tumors, 
      including non-small cell lung cancer. To date, whether ICIs could be a treatment 
      option for M-MN patients with PD-L1 expression and or high tumor mutation burden 
      (TMB) level has not been documented. PATIENT CONCERNS: A 68-year-old male patient 
      presented with edema of the lower limbs with increased urine foam in August 2018. 
      Biopsy on the right kidney showed MN at stage I with subepithelially localized 
      immune deposits. DIAGNOSIS: Lung squamous cell carcinoma (LSCC)-associated MN 
      with PD-L1 expression (20%) and high TMB level (26.2 mutations/Mb). 
      INTERVENTIONS: The patient received immunosuppressive therapy targeting the 
      initially diagnosed primary MN as first-line treatment plus surgery and 
      radiochemotherapy following pembrolizumab targeting the definitively diagnosed 
      lung cancer as second-line treatment. OUTCOMES: The patient benefited from 
      radiochemotherapy following pembrolizumab (lasting more than 38 months) rather 
      than immunosuppressive therapy. LESSONS: Our work suggests that combined ICIs 
      might be an effective treatment option for M-MN patients who harbor PD-L1 
      expression. Our work highlights that the presence of malignancy should not be 
      neglected at the initial diagnosis of MN.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Chen, Feifei
AU  - Chen F
AD  - Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical 
      University, Nanjing, China.
FAU - Du, Haiwei
AU  - Du H
AD  - Burning Rock Biotech, Guangzhou, China.
FAU - Fang, Surong
AU  - Fang S
AUID- ORCID: 0000-0002-8914-8153
AD  - Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical 
      University, Nanjing, China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - DPT0O3T46P (pembrolizumab)
RN  - 0 (B7-H1 Antigen)
SB  - IM
MH  - Male
MH  - Humans
MH  - Aged
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy
MH  - *Lung Neoplasms/drug therapy
MH  - B7-H1 Antigen/metabolism
MH  - *Glomerulonephritis, Membranous/therapy/drug therapy
MH  - *Carcinoma, Squamous Cell/drug therapy
MH  - Chemoradiotherapy
MH  - Lung/pathology
PMC - PMC9857441
EDAT- 2023/01/27 06:00
MHDA- 2023/01/31 06:00
PMCR- 2023/01/20
CRDT- 2023/01/26 16:23
PHST- 2023/01/26 16:23 [entrez]
PHST- 2023/01/27 06:00 [pubmed]
PHST- 2023/01/31 06:00 [medline]
PHST- 2023/01/20 00:00 [pmc-release]
AID - 00005792-202301200-00019 [pii]
AID - 10.1097/MD.0000000000032508 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Jan 20;102(3):e32508. doi: 
      10.1097/MD.0000000000032508.