Complete and durable response of pulmonary large-cell neuroendocrine carcinoma to pembrolizumab.
complete response
immune checkpoint inhibitor
pembrolizumab
plasma cell
pulmonary large cell neuroendocrine carcinoma
Journal
Cancer reports (Hoboken, N.J.)
ISSN: 2573-8348
Titre abrégé: Cancer Rep (Hoboken)
Pays: United States
ID NLM: 101747728
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
revised:
21
09
2021
received:
28
07
2021
accepted:
25
10
2021
pubmed:
25
11
2021
medline:
9
8
2022
entrez:
24
11
2021
Statut:
ppublish
Résumé
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive tumor with a poor prognosis and standard therapy has not yet been established. A 65-year-old male with a cough for 2 months presented to our hospital. He was clinically diagnosed with non small cell lung cancer cT3N1M0 stage IIIA and underwent right pneumonectomy. The final diagnosis was pulmonary LCNEC pT3N1M0 stage IIIA. Multiple subcutaneous masses were detected 4 months after surgery, and biopsy revealed postoperative recurrence and metastasis. Chemotherapy with carboplatin plus etoposide was initiated. Subcutaneous masses increased and multiple new brain metastases developed after two cycles. Additional tests revealed that epidermal growth factor receptor and anaplastic lymphoma kinase were negative, and the programmed death ligand 1 (PD-L1) expression rate in tumor cells was 40% (22C3 clones). The primary cells infiltrating the tumor were CD3-positive T cells and CD138-positive plasma cells. Second-line treatment with pembrolizumab was started. The shrinkage of subcutaneous masses was observed after one cycle, and the tumor had completely disappeared after six cycles. Treatment was continued for approximately 2 years. This response has been maintained for 4 years and is still ongoing. Pembrolizumab may be used as a treatment option for pulmonary LCNEC.
Sections du résumé
BACKGROUND
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive tumor with a poor prognosis and standard therapy has not yet been established.
CASE
A 65-year-old male with a cough for 2 months presented to our hospital. He was clinically diagnosed with non small cell lung cancer cT3N1M0 stage IIIA and underwent right pneumonectomy. The final diagnosis was pulmonary LCNEC pT3N1M0 stage IIIA. Multiple subcutaneous masses were detected 4 months after surgery, and biopsy revealed postoperative recurrence and metastasis. Chemotherapy with carboplatin plus etoposide was initiated. Subcutaneous masses increased and multiple new brain metastases developed after two cycles. Additional tests revealed that epidermal growth factor receptor and anaplastic lymphoma kinase were negative, and the programmed death ligand 1 (PD-L1) expression rate in tumor cells was 40% (22C3 clones). The primary cells infiltrating the tumor were CD3-positive T cells and CD138-positive plasma cells. Second-line treatment with pembrolizumab was started. The shrinkage of subcutaneous masses was observed after one cycle, and the tumor had completely disappeared after six cycles. Treatment was continued for approximately 2 years. This response has been maintained for 4 years and is still ongoing.
CONCLUSION
Pembrolizumab may be used as a treatment option for pulmonary LCNEC.
Identifiants
pubmed: 34817132
doi: 10.1002/cnr2.1589
pmc: PMC9351647
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Carboplatin
BG3F62OND5
pembrolizumab
DPT0O3T46P
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1589Informations de copyright
© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.
Références
Oncol Res Treat. 2018;41(5):306-312
pubmed: 29742518
Lancet. 2016 Apr 9;387(10027):1540-1550
pubmed: 26712084
QJM. 2019 Jun 26;:
pubmed: 31250021
J Immunother Cancer. 2021 Feb;9(2):
pubmed: 33597218
Nat Med. 2015 Aug;21(8):938-945
pubmed: 26193342
Immunotherapy. 2020 Mar;12(4):223-227
pubmed: 32156177
Oncoimmunology. 2021 Mar 29;10(1):1900508
pubmed: 33854820
Onco Targets Ther. 2020 Aug 19;13:8245-8250
pubmed: 32884302
Cancer Rep (Hoboken). 2022 Aug;5(8):e1589
pubmed: 34817132
Thorac Cancer. 2018 Jun;9(6):750-753
pubmed: 29667757
J Immunother Cancer. 2017 Sep 19;5(1):75
pubmed: 28923100
Thorac Cancer. 2020 Jul;11(7):2036-2039
pubmed: 32379390
J Thorac Oncol. 2018 May;13(5):636-648
pubmed: 29378266
N Engl J Med. 2015 May 21;372(21):2018-28
pubmed: 25891174
Oncotarget. 2018 Feb 22;9(18):14738-14740
pubmed: 29581877
Lung Cancer. 2019 Feb;128:53-56
pubmed: 30642453
Chemotherapy. 2021;66(3):65-71
pubmed: 33827084
Mol Clin Oncol. 2020 Jul;13(1):43-47
pubmed: 32499913
Clin Lung Cancer. 2016 Sep;17(5):e121-e129
pubmed: 26898325
Cancer Lett. 2013 Jun 10;333(2):222-8
pubmed: 23370224
Lung Cancer. 2017 Jun;108:115-120
pubmed: 28625622