Key result
Pembrolizumab shows divergent clinical outcomes in two patients with lung adenocarcinoma and paraneoplastic hypereosinophilia.
Why the study?
Paraneoplastic hypereosinophilia is an underrecognized solid tumor manifestation, and the clinical significance of persistent or severe hypereosinophilia during immune checkpoint inhibitor therapy remains incompletely understood.
Case Report (n=2)
Paraneoplastic hypereosinophilia in lung adenocarcinoma treated with pembrolizumab can have a heterogeneous clinical course, highlighting its uncertain role as a prognostic biomarker.
Answers are grounded in this paper and cite their sources.
Variable eosinophil responses in lung adenocarcinoma warrant caution against using them as PD-1 response biomarkers; case reports leave open their predictive role.
Paraneoplastic hypereosinophilia (PHE) is an underrecognized manifestation of solid tumors, particularly non-small cell lung cancer. We present two cases of metastatic lung adenocarcinoma with marked eosinophilia treated with PD-1 inhibitor immunotherapy, both of whom demonstrated changes in eosinophil counts but divergent clinical outcomes. While elevated eosinophil levels during immune checkpoint inhibitor therapy have been associated with improved treatment response in prior studies, the clinical significance of persistent or severe hypereosinophilia remains incompletely understood. These cases highlight the heterogeneous course of paraneoplastic hypereosinophilia and underscore the potential—yet uncertain—role of eosinophils as prognostic biomarkers in oncology, warranting further investigation to clarify the role of PHE as a prognostic or predictive biomarker in oncology.
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Oza et al. (2026) conducted a case report in Lung adenocarcinoma with paraneoplastic hypereosinophilia (n=2). Pembrolizumab was evaluated. Two patients with lung adenocarcinoma and paraneoplastic hypereosinophilia treated with pembrolizumab demonstrated divergent clinical outcomes, highlighting the heterogeneous course of this condition.
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