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Case Report Open Access

Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report

  • Authors:
    • Yuki Maze
    • Takahiro Mitsumura
    • Hiroshi Nakahama
    • Tatsuya Kato
    • Yui Takahashi
    • Yuichiro Nei
    • Shigeo Hanada
    • Atsushi Miyamoto
    • Hironori Uruga
    • Takeshi Fujii
    • Meiyo Tamaoka
  • View Affiliations / Copyright

    Affiliations: Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo 105‑8470, Japan, Department of Pathology, Toranomon Hospital, Tokyo 105‑8470, Japan
    Copyright: © Maze et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 542
    |
    Published online on: September 22, 2025
       https://doi.org/10.3892/ol.2025.15288
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Abstract

Concurrent chemoradiotherapy (CCRT) followed by durvalumab consolidation is the standard treatment for patients with locally advanced non‑small cell lung cancer (NSCLC) with a good performance status. However, there is currently no consensus on the management of recurrence after CCRT and durvalumab consolidation therapy. The present study describes the case of a 52‑year‑old male former smoker with stage IIIB NSCLC who experienced recurrence in the right hilar, mediastinal and bilateral supraclavicular lymph nodes after an initial response to CCRT and durvalumab. A treatment regimen involving combined durvalumab, tremelimumab, cisplatin and pemetrexed achieved stable disease and was continued as maintenance therapy. However, the patient later developed brain and bone metastases, indicating progressive disease. This case highlights the challenges of managing recurrent NSCLC after CCRT and durvalumab consolidation therapy. Combining immunotherapy and chemotherapy may offer a viable approach, underscoring the need for further research and standardized protocols.
View Figures

Figure 1

(A) Chest CT revealed a 23-mm
irregular nodular lesion with spiculated margins in the left upper
lobe hilum, suspected to be the primary tumor. (B) Enlarged right
lower paratracheal and left lower paratracheal lymph nodes. (C)
Enlarged left hilar lymph node. (D) Enlarged right upper
paratracheal lymph node. (E) 18F-FDG positron emission
tomography/CT showed high FDG uptake in the right lower
paratracheal lymph node (SUVmax, 7.71) and the left lower
paratracheal lymph node (SUVmax, 7.83). (F) High FDG uptake in the
irregular left upper lobe mass near the hilum, suspected to be the
primary tumor (SUVmax, 16.73), and in the left hilar lymph node
(SUVmax, 9.39). (G) High FDG uptake in the right upper paratracheal
lymph node (SUVmax, 5.44). (H) No abnormal FDG uptake suggestive of
other distant metastases was observed. (I) Pathological findings
revealed atypical cells with hyperchromatic nuclei proliferating
while exhibiting a poorly formed glandular structure, indicative of
adenocarcinoma. (J) Dual immunostaining: TTF-1 (nucleus) positive,
CK5/6 (cytoplasm) negative. (K) Dual immunostaining: Napsin A
(cytoplasm) positive, p40 (nucleus) negative. (L) Hepatocyte
nuclear factor 4 alpha was negative. (M) Programmed death-ligand 1
immunostaining revealed a tumor proportion score of less than 1%.
Arrows indicate the primary tumor in (A), the right and left lower
paratracheal nodes in (B), the left hilar node in (C), and the
right upper paratracheal node in (D). 18F-FGD,
18F-fluorodeoxyglucose; CT, computed tomography; SUVmax,
standardized uptake value.

Figure 2

(A) Imaging and therapeutic response
before and during treatment. (B) Prior to treatment, an irregular
mass was observed near the hilum of the left upper lobe,
accompanied by enlargement of the mediastinal and left hilar lymph
nodes. (C) Chest CT after concurrent chemoradiotherapy, showing a
partial response; the arrow indicates the primary lesion. (D) CT
after 5 cycles of durvalumab, showing a partial response; the arrow
indicates the primary lesion. (E) CT after 8 cycles of durvalumab,
showing progressive disease; the arrows indicate metastatic lesions
in the right hilar and mediastinal lymph nodes. (F) CT after 4
cycles of cisplatin plus pemetrexed plus tremelimumab plus
durvalumab, showing stable disease. CCRT, concurrent
chemoradiotherapy; CT, computed tomography; PD, progressive
disease; PR, partial response; SD, stable disease.

Figure 3

(A) Imaging and therapeutic response
before and during treatment. (B) MRI and 18F-FDG PET/CT
after 5 cycles of maintenance therapy with durvalumab + pemetrexed,
showing progressive disease; the arrows indicate cerebellar
metastasis and supraclavicular lymph node metastasis, respectively.
(C) CT after 3 cycles of CBDCA plus nab-PTX, showing stable
disease; the arrow indicates supraclavicular lymph node metastasis.
(D) MRI after 3 cycles of CBDCA plus nab-PTX, showing stable
disease; the arrows indicate cerebellar metastasis.
18F-FDG PET, 18F-fluorodeoxyglucose positron
emission tomography; CBDCA, carboplatin; CT, computed tomography;
nab-PTX, nab-paclitaxel; PD, progressive disease; SD, stable
disease.
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Copy and paste a formatted citation
Spandidos Publications style
Maze Y, Mitsumura T, Nakahama H, Kato T, Takahashi Y, Nei Y, Hanada S, Miyamoto A, Uruga H, Fujii T, Fujii T, et al: Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report. Oncol Lett 30: 542, 2025.
APA
Maze, Y., Mitsumura, T., Nakahama, H., Kato, T., Takahashi, Y., Nei, Y. ... Tamaoka, M. (2025). Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report. Oncology Letters, 30, 542. https://doi.org/10.3892/ol.2025.15288
MLA
Maze, Y., Mitsumura, T., Nakahama, H., Kato, T., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report". Oncology Letters 30.6 (2025): 542.
Chicago
Maze, Y., Mitsumura, T., Nakahama, H., Kato, T., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report". Oncology Letters 30, no. 6 (2025): 542. https://doi.org/10.3892/ol.2025.15288
Copy and paste a formatted citation
x
Spandidos Publications style
Maze Y, Mitsumura T, Nakahama H, Kato T, Takahashi Y, Nei Y, Hanada S, Miyamoto A, Uruga H, Fujii T, Fujii T, et al: Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report. Oncol Lett 30: 542, 2025.
APA
Maze, Y., Mitsumura, T., Nakahama, H., Kato, T., Takahashi, Y., Nei, Y. ... Tamaoka, M. (2025). Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report. Oncology Letters, 30, 542. https://doi.org/10.3892/ol.2025.15288
MLA
Maze, Y., Mitsumura, T., Nakahama, H., Kato, T., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report". Oncology Letters 30.6 (2025): 542.
Chicago
Maze, Y., Mitsumura, T., Nakahama, H., Kato, T., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Efficacy of combined immunotherapy and chemotherapy in recurrent non‑small cell lung cancer during durvalumab maintenance therapy: A case report". Oncology Letters 30, no. 6 (2025): 542. https://doi.org/10.3892/ol.2025.15288
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