Combination of PD-1 inhibitor and chemotherapy for subcutaneous soft-tissue metastasis in postoperative non-small cell lung cancer

RATIONALE: Despite available therapies, patients with advanced non-small cell lung cancer have a poor prognosis, highlighting the need for novel treatment strategies. The combination of immune checkpoint inhibitors and chemotherapy represents a promising approach. This case report describes the efficacy and safety of this combination in a patient with aggressive metastatic disease. PATIENT CONCERNS: A 60-year-old male patient, who had undergone surgical resection for primary lung adenocarcinoma, presented with newly developed subcutaneous nodules and symptoms suggestive of adrenal involvement during routine follow-up. DIAGNOSES: Histopathological and imaging examinations confirmed recurrent lung adenocarcinoma with metastases to the subcutaneous soft tissues and the adrenal gland. INTERVENTIONS: The patient received platinum-based doublet chemotherapy combined with pembrolizumab (an anti-programmed cell death protein 1inhibitor) as second-line systemic therapy. OUTCOMES: Following several treatment cycles, imaging revealed marked regression of metastatic lesions, with only minimal treatment-related adverse events reported. The patient achieved a durable clinical response. LESSONS: This case suggests that combining chemotherapy with programmed cell death protein 1 inhibition may provide rapid and effective tumor control in advanced non-small cell lung cancer patients with bulky, symptomatic metastases, while maintaining a manageable safety profile. Further clinical trials are warranted to validate this approach.