PMC8739789_01
Chest CT images throughout the disease course. (A) Initial evaluation showed enlarged mediastinal lymph node. (B) Partial response (PR) after docetaxel-cisplatin. (C) Progressive disease after four cycles of docetaxel-cisplatin. (D) PR after afatinib. (E) Progressive disease after 2 months of afatinib. (F) Hyperprogressive disease after one cycle of pembrolizumab. PD-L1 expression before (G) and after (H) pembrolizumab monotherapy.
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Chest CT scan ( Figure 1 ) showed right lower lung mass with multiple mediastinal lymph nodes enlargement. Chest CT ( Figure 1 ) revealed that the tumor rapidly progressed with massive pleural effusion and significantly enlarged mediastinal lymph nodes.
Tumor mircoenvironmental features before and after pembrolizumab treatment.
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CD8, CD56, CD68, HLA-DR, and panCK, and quite interestingly, after pembrolizumab, CD8+ T cells were recruited only in tumor stroma without infiltrating tumor parenchyma. Concomitantly, tumor-associated macrophages were dramatically elevated; by contrast, CD56dim NK cells in tumor parenchyma were decreased ( Figure 2 ).