[A Case of a Patient with Lung Adenocarcinoma on Hemodialysis Treated with Atezolizumab+Carboplatin+Nab-Paclitaxel].

A 70-year-old man presented with anorexia and cough, and CT showed an infiltrative shadow in the right upper lobe. Bronchoscopy revealed unresectable advanced lung carcinoma(cT4N2M1a, cStage ⅣA). The patient had chronic renal failure due to type 2 diabetes mellitus and had been undergoing hemodialysis for 6 years. Four courses of primary chemotherapy( atezolizumab+carboplatin[CBDCA]+nab-paclitaxel[nab-PTX][atezolizumab 1,200 mg/body weight, CBDCA target AUC=5, nab-PTX 100 mg/m2 every 3 weeks])were administered. Thereafter, 3 courses of maintenance treatment with atezolizumab alone(1,200 mg/body weight every 3 weeks)were administered. At this point, the primary tumor was enlarged, and the patient was diagnosed with progressive disease(PD). After 4 courses of second-line chemotherapy with docetaxel(DTX)+ramucirumab(RAM)(DTX 60 mg/m2 day 1, RAM 8 mg/kg day 1, 15, every 4 weeks), the primary tumor temporarily shrank but then re-expanded; therefore, the patient remained in a state of PD. The general condition deteriorated, and he was referred to the palliative care department where he died peacefully.