PMC5109681_01
Disease course timeline for patient 1. -Pleural effusion requiring thoracentesis. -Pericardiocentesis for pericardial tamponade. -First noted to have pericardial effusion on imaging. SCLC - Small Cell Lung Cancer, EP - period during which disease was controlled using several cycles of Etoposide + Platinum, 2nd and 3rd line - period during which several second and third line agents were used including topotecan, everolimus, temozolamide, docetaxel and sunitinib
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Fig1
He had a low-grade disease and favorable response to various therapies, and a prolonged disease course as delineated in Fig. 1. He further experienced pericardial effusion with tamponade requiring pericardiocentesis on week 9 after initiation of nivolumab (Fig. 1).
Top- PET-CT images July 2015 showing 3.2 cm left para-tracheal mass with SUV 6.8 (a) and 4.6 x 3.1 cm right para-tracheal mass with SUV 6.5 (b). Also seen are large right and small left pleural effusions. Bottom- PET-CT images from December 2015 showing complete resolution of left para-tracheal mass, and decreased size of right para-tracheal mass with equivocal hypermetabolism (SUV 2.6) along with complete resolution of left pleural effusion and residual small right pleural effusion
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Fig2
He had evidence of partial response at 8 weeks of therapy and near complete response at 16 weeks of therapy in December 2015 (Fig. 2).
PMC5109681_02
Disease course timeline for patient 2. -Pleural effusion requiring thoracentesis. -Pericardial tamponade requiring pericardiocentesis. N- Nivolumab
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Fig3
She developed recurrent right pleural effusions requiring four thoracenteses over the next 8 weeks (Fig. 3).