Overcoming Primary Resistance to PD-1 Inhibitor With Anti–PD-L1 Agent in Squamous-Cell NSCLC: Case Report

Clinical Practice Points •Immune checkpoint inhibitors (ICI) have changed the treatment landscape of advanced non–small-cell lung cancer, as they have shown their superiority to chemotherapy in the first-line setting in tumors having programmed death ligand 1 (PD-L1) expression ≥ 50% and in patients with pretreated disease, regardless of PD-L1 expression. • The efficacy and safety of ICI rechallenge in those patients whose disease failed to respond to a prior treatment with these agents remain unclear. • We report the case of a 79-year-old woman, a smoker, with locally advanced, TP53-mutated squamous non–small-cell lung cancer, whose disease responded to an anti–PD-L1 agent despite having experienced disease progression during a prior anti–programmed cell death 1 treatment that followed first-line chemoradiotherapy. The anti–PD-L1 therapy was still ongoing after 9 months. • Our case suggests that ICI rechallenge could be safe and effective, even in a subpopulation of patients with disease that did not respond to prior ICI therapy.