ArticleFrontiers in immunology2026
Case Report: Long-term survival in advanced PD-L1-high squamous cell lung cancer following severe immune-related cardiotoxicity.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The introduction of immune checkpoint inhibitors (ICIs) has reshaped the therapeutic landscape of advanced non-small cell lung cancer. However, immune-related adverse events (irAEs), including rare cases of life-threatening cardiotoxicity, pose a significant challenge for subsequent therapy selection. Evidence on optimal post-ICI strategies, particularly in patients who have experienced severe irAEs, remains limited. Herein, we report the case of a 58-year-old male smoker with stage IVA squamous cell lung carcinoma (cT4N3M1a, PD-L1 TPS 60%, EGFR wild-type) who developed grade 3 immune-mediated myocarditis after receiving chemoimmunotherapy, leading to permanent ICI discontinuation. After improvement of the immune-related myocarditis, the patient was administered second- and third-line treatment. The patient achieved a progression-free survival of 31 months following third-line treatment, with an overall survival of 43 months. This case demonstrated successful reversal of severe immune-related cardiac toxicity in a patient with advanced squamous cell lung cancer with high PD-L1 expression through personalized, precise, and multidisciplinary team diagnosis and treatment, achieving prolonged overall survival. Furthermore, this case suggested that anti-angiogenic therapy (anlotinib) can be safely administered as subsequent treatment for lung squamous cell carcinoma following recovery from severe immune-related cardiotoxicity.
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