TY - JOUR T1 - Progression vs. pseudo progression in the treatment of squamous NSCLC with nivolumab JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA4845 VL - 48 IS - suppl 60 SP - PA4845 AU - Stefan Rudiger AU - Cornelia Kropf-Sanchen AU - Gerlinde Schmidtke-Schrezenmeier AU - Marta Aksentiy AU - Katja Hoss AU - Wolfgang Rottbauer Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA4845.abstract N2 - Introduction: Immunotherapy has revolutionized treatment in squamous NSCLC. Along with the superior efficacy physicians have to face new side effects and response criteria. Initial tumor growth or new lesions followed by tumor response is called pseudo progression and can be seen in up to 10 % of patients.Patient 1: A 68 year old woman with squamous NSCLC stage IIIA received a tumor resection and adjuvant chemotherapy. Within 6 month tumor was seen in mediastinal lymph nodes and radiation therapy was applied. A few month later tumor progressed with multiple pulmonary nodules. After 4 courses of Nivolumab pulmonary metastases showed growth again. Assuming pseudo progression treatment was continued and the next CT scan revealed progressive disease again.Patient 2: A 60 year old woman with squamous NSCLC stage IIIB received a systemic therapy due to a suspected bone lesion. Concurrent radiochemotherapy was administered due to little probability of bone metastasis. 6 month later brain metastases appeared and were treated locally, but soon systemic progression with lung metastases was registered. After 4 courses of Nivolumab pulmonary metastases showed growth again. Assuming pseudo progression treatment was continued and the next CT scan revealed reduction in pulmonary nodules. The patient is still on treatment for more than six month.Conclusion: Pseudo progression is only seen in a small part of patients treated with immunotherapy. With little tumor burden a treatment continuation can be feasible. Also patients who are not considered fit for second line chemotherapy may continue treatment. Aggressive tumor growth or high tumor load should stay a domain of conventional second line chemotherapy. ER -