--- a
+++ b/processing/MACCROBAT/28121940.txt
@@ -0,0 +1,13 @@
+A 68-year-old female smoker with a history of pulmonary embolism and diabetes mellitus was diagnosed with Stage IIIB (T4N2M0) squamous NSCLC.
+She was treated by definitive chemoradiotherapy with cisplatin and vinorelbine until September 2014.
+In October 2014, positron emission tomography–computed tomography (PET-CT) scan demonstrated a good response in the primary lesion; however, new metastases in the right adrenal gland and right femur developed and were irradiated in November 2014.
+A month later the disease progressed with development of multiple bone and subcutaneous metastases.
+At that point, the patient suffered from severe dyspnea and was oxygen-dependent.
+She received one cycle of carboplatin and gemcitabine followed by severe pancytopenia, and treatment was switched to nivolumab 3 mg/kg q14 days in January 2015.
+One week after the first cycle of nivolumab, a subcutaneous lesion in her upper back grew substantially, accompanied by severe pain and significant inflammatory reaction (Fig.1).
+Other subcutaneous metastases grew slightly as well.
+After the second cycle of treatment marked symptomatic improvement was observed, including improvement in general appearance and dyspnea and reduction of the bone pain.
+The patient no longer required oxygen supplementation.
+The subcutaneous lesions started to regress too, with complete resolution by the 12th week as well as improvement in all bone lesions (Figs.1 ​and 2).
+The patient continued on nivolumab until June 2015, and tolerated the treatment well.
+Unfortunately, she developed bacterial aspiration pneumonia and passed away in June 2015.