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Case Report Open Access

Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series

  • Authors:
    • Tatsuya Kato
    • Takahiro Mitsumura
    • Eiyu Tsuboi
    • Hiroshi Nakahama
    • 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 Diagnostic Pathology, Toranomon Hospital, Tokyo 105‑8470, Japan
    Copyright: © Kato et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 319
    |
    Published online on: May 29, 2026
       https://doi.org/10.3892/ol.2026.15674
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Abstract

Invasive mucinous adenocarcinoma (IMA) is a rare subtype of lung adenocarcinoma that frequently harbors KRAS mutations and exhibits low programmed death‑ligand 1 (PD‑L1) expression. As evidence on the use of immune checkpoint inhibitors (ICIs) for IMA is limited, the present study aimed to describe the clinical features, treatment patterns and outcomes to evaluate the effectiveness of ICIs for IMA. The present retrospective study included 15 patients with advanced or recurrent IMA who were treated at Toranomon Hospital (Tokyo, Japan) between April 2014 and March 2025. The present report focuses on 7 patients who received first‑line ICI‑based therapy. Patient characteristics, molecular and pathological features, treatments administered, and outcomes were summarized, and responses were assessed using the Response Evaluation Criteria in Solid Tumors version 1.1. Among the 15 patients, KRAS mutations were identified in 6 patients (40%), PD‑L1 expression was positive in 2 patients (13%), negative in 7 patients (47%) and unknown in 6 patients (40%). Of the 7 patients receiving first‑line ICI‑based therapy, 4 received dual ICIs and 3 received a single‑agent ICI. The best overall response among these patients was partial response (PR) in 1 patient (14%), stable disease in 5 patients (71%) and progressive disease in 1 patient (14%). A total of 5 patients (71%) experienced immune‑related adverse events leading to treatment discontinuation. In conclusion, first‑line ICI‑based therapies showed limited effectiveness overall. However, 3 patients treated with dual ICIs and chemotherapy achieved a 100% disease control rate, with 1 patient achieving a PR. Therefore, specific ICI‑based combination therapies may be a viable option for the treatment of IMA.
View Figures

Figure 1

CT images for case 3. (A) CT scan at
recurrence, demonstrating multiple metastatic nodules throughout
both lungs. (B) CT scan after the second cycle of dual immune
checkpoint inhibitors (durvalumab and tremelimumab) combined with
chemotherapy (carboplatin and nab-paclitaxel), showing SD. (C) CT
scan after the fourth cycle, showing partial response. CT, computed
tomography; PR, partial response; SD, stable disease.

Figure 2

CT images for case 5. In each panel,
the top and bottom rows display different axial slices obtained at
the same corresponding time point. (A) CT scan at diagnosis,
demonstrating consolidation in the left lower lobe and multiple
metastatic nodules and consolidation in both lungs, including the
right upper lobe. CT scans after the (B) second and (C) fourth
cycles of dual immune checkpoint inhibitors (durvalumab and
tremelimumab) combined with chemotherapy (cisplatin and
pemetrexed), showing PD. (D) CT scan after the third cycle of
maintenance therapy, showing SD. CT, computed tomography; PD,
progressive disease; SD, stable disease.
View References

1 

Nicholson AG, Tsao MS, Beasley MB, Borczuk AC, Brambilla E, Cooper WA, Dacic S, Jain D, Kerr KM, Lantuejoul S, et al: The 2021 WHO classification of lung tumors: impact of advances since 2015. J Thorac Oncol. 17:362–387. 2022. View Article : Google Scholar : PubMed/NCBI

2 

Schoenfeld AJ, Rizvi H, Bandlamudi C, Sauter JL, Travis WD, Rekhtman N, Plodkowski AJ, Perez-Johnston R, Sawan P, Beras A, et al: Clinical and molecular correlates of PD-L1 expression in patients with lung adenocarcinomas. Ann Oncol. 31:599–608. 2020. View Article : Google Scholar : PubMed/NCBI

3 

Di Federico A, Stumpo S, Mantuano F, De Gilglio A, Lo Bianco F Pecci F, Alessi JV, Wang X, Sperandi F, Melotti B, et al: Long-term overall survival with dual CTLA-4 and PD-L1 or PD-1 blockade and biomarker-based subgroup analyses in patients with advanced non-small-cell lung cancer: A systematic review and reconstructed individual patient data meta-analysis. Lancet Oncol. 26:1443–1453. 2025. View Article : Google Scholar : PubMed/NCBI

4 

Xu L, Li C and Lu H: Invasive mucinous adenocarcinoma of the lung. Transl Cancer Res. 8:2924–2932. 2019. View Article : Google Scholar : PubMed/NCBI

5 

Liang Y, Maeda O, Kondo C, Nishida K and Ando Y: Effects of KRAS, STK11, KEAP1, and TP53 mutations on the clinical outcomes of immune checkpoint inhibitors among patients with lung adenocarcinoma. PLoS One. 19:e03075802024. View Article : Google Scholar : PubMed/NCBI

6 

Xu M, Zhao X, Wen T and Qu X: Unveiling the role of KRAS in tumor immune microenvironment. Biomed Pharmacother. 171:1160582024. View Article : Google Scholar : PubMed/NCBI

7 

Jang YJ, Hyun DG, Choi CM, Lee DH, Kim SW, Yoon S, Kim WS, Ji W and Lee JC: Optimizing palliative chemotherapy for advanced invasive mucinous adenocarcinoma of the lung. BMC Cancer. 21:7312021. View Article : Google Scholar : PubMed/NCBI

8 

Kim SH, Seong H, Lee J, Ahn HY, Cho JS, I H, Kim YD, Lee MK, Eom JS and Kim MH: The role of local ablative therapy in patients with advanced invasive mucinous adenocarcinoma of the lung. J Cancer Res Clin Oncol. 150:4092024. View Article : Google Scholar : PubMed/NCBI

9 

Chae YK, Othus M, Patel SP, Gerber DE, Tanvetyanon T, Kim HS, Chung LI, McLeod CM, Lopez G, Chen HX, et al: Phase II trial of dual anti-CTLA-4 and anti-PD-1 blockade in rare tumors SWOG/NCI experience: Invasive mucinous or non-mucinous lepidic adenocarcinoma of the lung (formerly bronchioloalveolar carcinoma). Ther Adv Med Oncol. 16:175883592412934012024. View Article : Google Scholar : PubMed/NCBI

10 

Liu C, Zheng S, Wang Z, Wang S, Wang X, Yang L, Xu H, Cao Z, Feng X, Xue Q, et al: KRAS-G12D mutation drives immune suppression and the primary resistance of anti-PD-1/PD-L1 immunotherapy in non-small cell lung cancer. Cancer Commun (Lond). 42:828–847. 2022. View Article : Google Scholar : PubMed/NCBI

11 

Frost N, Zhamurashvili T, von Laffert M, Klauschen F, Ruwwe-Glösenkamp C, Raspe M, Brunn M, Ochsenreither S, Temmesfeld-Wollbrück B, Suttorp N, et al: Pemetrexed-based chemotherapy is inferior to pemetrexed-free regimens in thyroid transcription factor 1 (TTF-1)-Negative, EGFR/ALK-negative lung adenocarcinoma: A propensity score matched pairs analysis. Clin Lung Cancer. 21:e607–e621. 2020. View Article : Google Scholar : PubMed/NCBI

12 

Seymour L, Bogaerts J, Perrone A, Ford R, Schwartz LH, Mandrekar S, Lin NU, Litière S, Dancey J, Chen A, et al: iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics. Lancet Oncol. 18:e143–e152. 2017. View Article : Google Scholar : PubMed/NCBI

13 

Yanada H, Yoshida R, Kida R, Nitanai K, Ikeda M, Nagasue K, Naraoka T, Ueda M, Watanabe T and Shigaki R: Sotorasib resistance in KRAS G12C-mutant invasive mucinous adenocarcinoma with implications for VEGF-A. NPJ Precis Oncol. 9:1542025. View Article : Google Scholar : PubMed/NCBI

14 

Yamakawa H, Takayanagi N, Ishiguro T, Kagiyama N, Shimizu Y and Sugita Y: A favorable response to cisplatin, pemetrexed and bevacizumab in two cases of invasive mucinous adenocarcinoma formerly known as pneumonic-type mucinous bronchioloalveolar carcinoma. Intern Med. 52:2781–2784. 2013. View Article : Google Scholar : PubMed/NCBI

15 

Sun XW, Ding YJ, Zhang YY, Chen PL, Yan YR, Shen JM and Li QY: Favorable response to pemetrexed, cisplatin and bevacizumab in invasive mucinous adenocarcinoma: A case report and literature review. Mol Clin Oncol. 9:192–196. 2018.PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Kato T, Mitsumura T, Tsuboi E, Nakahama H, Takahashi Y, Nei Y, Hanada S, Miyamoto A, Uruga H, Fujii T, Fujii T, et al: Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series. Oncol Lett 32: 319, 2026.
APA
Kato, T., Mitsumura, T., Tsuboi, E., Nakahama, H., Takahashi, Y., Nei, Y. ... Tamaoka, M. (2026). Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series. Oncology Letters, 32, 319. https://doi.org/10.3892/ol.2026.15674
MLA
Kato, T., Mitsumura, T., Tsuboi, E., Nakahama, H., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series". Oncology Letters 32.1 (2026): 319.
Chicago
Kato, T., Mitsumura, T., Tsuboi, E., Nakahama, H., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series". Oncology Letters 32, no. 1 (2026): 319. https://doi.org/10.3892/ol.2026.15674
Copy and paste a formatted citation
x
Spandidos Publications style
Kato T, Mitsumura T, Tsuboi E, Nakahama H, Takahashi Y, Nei Y, Hanada S, Miyamoto A, Uruga H, Fujii T, Fujii T, et al: Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series. Oncol Lett 32: 319, 2026.
APA
Kato, T., Mitsumura, T., Tsuboi, E., Nakahama, H., Takahashi, Y., Nei, Y. ... Tamaoka, M. (2026). Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series. Oncology Letters, 32, 319. https://doi.org/10.3892/ol.2026.15674
MLA
Kato, T., Mitsumura, T., Tsuboi, E., Nakahama, H., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series". Oncology Letters 32.1 (2026): 319.
Chicago
Kato, T., Mitsumura, T., Tsuboi, E., Nakahama, H., Takahashi, Y., Nei, Y., Hanada, S., Miyamoto, A., Uruga, H., Fujii, T., Tamaoka, M."Immune checkpoint inhibitors for invasive mucinous adenocarcinoma: A case series". Oncology Letters 32, no. 1 (2026): 319. https://doi.org/10.3892/ol.2026.15674
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