A Case of Granulocyte Colony-Stimulating Factor-Producing Lung Adenocarcinoma with KRAS G12V Mutation…

Abstract

We report a rare case of granulocyte colony-stimulating factor (G-CSF)-producing lung adenocarcinoma with a high PD-L1 expression and a KRAS G12V mutation that responded to pembrolizumab. A 72-year-old man presented with leukocytosis, elevated serum G-CSF levels, a diffuse bone marrow fluorodeoxyglucose uptake, and a rapidly progressive lung mass. A biopsy revealed TTF-1 positive adenocarcinoma with a PD-L1 tumor proportion score of 100 % and a KRAS G12V mutation. Pembrolizumab induced marked tumor regression and normalization of the G-CSF levels. However, immune-related pneumonitis resulted in treatment discontinuation. Pembrolizumab may be effective in selected patients with G-CSF-producing lung cancer despite its typically aggressive clinical behavior.

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BibTeX

@article{arai2026case,
  title = {{A Case of Granulocyte Colony-Stimulating Factor-Producing Lung Adenocarcinoma with KRAS G12V Mutation Responding to Pembrolizumab}},
  author = {Katsunori Arai and Hirokazu Tokuyasu and Shuichi Matsuoka and Hiromitsu Sakai and Chika Esumi and Akira Yamasaki},
  journal = {Internal Medicine},
  year = {2026},
  month = jul,
  doi = {10.2169/internalmedicine.7754-26},
  url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7754-26/_article},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - A Case of Granulocyte Colony-Stimulating Factor-Producing Lung Adenocarcinoma with KRAS G12V Mutation Responding to Pembrolizumab
AU  - Katsunori Arai
AU  - Hirokazu Tokuyasu
AU  - Shuichi Matsuoka
AU  - Hiromitsu Sakai
AU  - Chika Esumi
AU  - Akira Yamasaki
PY  - 2026
DA  - 2026/07/11
JO  - Internal Medicine
DO  - 10.2169/internalmedicine.7754-26
UR  - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7754-26/_article
AB  - We report a rare case of granulocyte colony-stimulating factor (G-CSF)-producing lung adenocarcinoma with a high PD-L1 expression and a KRAS G12V mutation that responded to pembrolizumab. A 72-year-old man presented with leukocytosis, elevated serum G-CSF levels, a diffuse bone marrow fluorodeoxyglucose uptake, and a rapidly progressive lung mass. A biopsy revealed TTF-1 positive adenocarcinoma with a PD-L1 tumor proportion score of 100 % and a KRAS G12V mutation. Pembrolizumab induced marked tumor regression and normalization of the G-CSF levels. However, immune-related pneumonitis resulted in treatment discontinuation. Pembrolizumab may be effective in selected patients with G-CSF-producing lung cancer despite its typically aggressive clinical behavior.
SN  - 1349-7235
SN  - 0918-2918
ER  -

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