PMC10359695_01
Histological findings of invasive ductal carcinoma with programmed death-ligand 1 (PD-L1) positivity. a Hematoxylin and eosin staining showing invasive ductal carcinoma. b, c Immunohistochemistry images showing expression of PD-L1. b PD-L1 (clone 22C3). c PD-L1 (clone SP142).
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F1
The combined positive score for PD-L1 (clone 22C3) expression was 30%, and PD-L1 (clone SP142) expression on tumor-infiltrating immune cells as a percentage of tumor area accounted for 10% (Fig. 1).
Positron emission tomography/computed tomography image showing multiple lung metastases, pleural dissemination, pleural effusion, and supraclavicular node metastasis. The arrow indicates the supraclavicular node metastasis.
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F2
Five and a half years after the left breast surgery, positron emission tomography/computed tomography revealed multiple lung metastases, pleural dissemination, pleural effusion, and supraclavicular node metastasis (Fig. 2).
Changes in the levels of cancer antigen 15-3 (CA15-3) and carcinoembryonic antigen (CEA) from the first-line treatment to the end of the third-line treatment.
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F3
Computed tomography revealed disease progression (Fig. 3, 4a, b). Two cycles of pembrolizumab, gemcitabine, and carboplatin were administered as third-line therapy; however, the CA15-3 level rose rapidly and computed tomography revealed the growth of liver metastasis, suggesting that the treatment failed (Fig. 3, 4d).
Computed tomography images showing lung metastases, pleural dissemination, pleural effusion, and liver metastasis during the course of treatments. a Before the administration of atezolizumab plus nab-paclitaxel. b After 4 months of treatment with atezolizumab plus nab-paclitaxel. c After 4 months of treatment with olaparib. d After 2 months of treatment with pembrolizumab plus gemcitabine plus carboplatin. The arrow indicates liver metastasis.
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F4
Computed tomography revealed disease progression (Fig. 3, 4a, b). However, the CA15-3 level increased again and liver metastasis was found 4 months after the administration, although pleural effusion had subsided (Fig. 4c). Two cycles of pembrolizumab, gemcitabine, and carboplatin were administered as third-line therapy; however, the CA15-3 level rose rapidly and computed tomography revealed the growth of liver metastasis, suggesting that the treatment failed (Fig. 3, 4d).