Dai Gangyi, He Lang, Yan Qin, Li Yamao, Huang Yuandong, Li Bin, Wang Guoping
Department of Oncology, the Chengdu Fifth People's Hospital, Chengdu, Sichuan, China.
Affiliated Chengdu Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine (Second Clinical Medical School), Chengdu Institute of Cancer Prevention and Control, Chengdu, Sichuan, China.
Front Oncol. 2023 Jun 30;13:1167516. doi: 10.3389/fonc.2023.1167516. eCollection 2023.
Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of non-small-cell lung cancer (NSCLC), which is resistant to conventional chemotherapy and radiotherapy with a poor prognosis. The MET inhibitor may be effective for the patients with MET exon 14 skipping mutation. This mutation was not detected in this patient. However, the PD-L1 TPS 60%, KRAS and TP53 mutations were detected in this patient could benefited from immunotherapy. The anlotinib is a novel multitarget antiangiogenic drug that could be effective for advanced non-small-cell lung cancer and some sarcoma patients. We report a patient with advanced pulmonary sarcomatoid carcinoma successfully treated with immunotherapy combined with antiangiogenic drugs.
A 75-year-old male was admitted to the hospital in July 2020 because of productive cough for more than three months. The patient was diagnosed with advanced pulmonary sarcomatoid carcinoma with adrenal gland metastasis (cT4N3M1b, stage IVA) was treated in our hospital. Genetic testing revealed KRAS P.L19F mutation (abundance 19.12%) and NFEE2L2 P.E82G mutation (abundance 14.84%); TP53 P.S183 mutation (abundance 26.97%), TMB(Tumor Mutational Burden) 30.91 muts/Mb, MSS, and PD-L1 (Daco 22C3) TPS 60% were also detected. We administrated sintilimab combined with anlotinib treatment, a PD-1 inhibitor with antiangiogenic drug. The patient achieved a favorable outcome with tolerable adverse effects.
Sintilimab combined with anlotinib treatment may lead to a favorable outcome for patients with advanced pulmonary sarcomatoid carcinoma.
肺肉瘤样癌（PSC）是一种罕见的非小细胞肺癌（NSCLC）亚型，对传统化疗和放疗耐药，预后较差。MET抑制剂可能对存在MET外显子14跳跃突变的患者有效。该患者未检测到这种突变。然而，该患者检测到PD-L1肿瘤比例评分（TPS）为60%，KRAS和TP53突变，可能从免疫治疗中获益。安罗替尼是一种新型多靶点抗血管生成药物，对晚期非小细胞肺癌和一些肉瘤患者可能有效。我们报告1例晚期肺肉瘤样癌患者成功接受免疫治疗联合抗血管生成药物治疗。
一名75岁男性因咳嗽伴咳痰3个多月于2020年7月入院。该患者被诊断为晚期肺肉瘤样癌伴肾上腺转移（cT4N3M1b，IVA期），在我院接受治疗。基因检测显示KRAS基因第19位密码子发生P.L19F突变（丰度19.12%）和NFEE2L2基因第82位密码子发生P.E82G突变（丰度14.84%）；还检测到TP53基因第183位密码子发生P.S183突变（丰度26.97%）、肿瘤突变负荷（TMB）为30.91个突变/Mb、微卫星稳定（MSS）以及PD-L1（Daco 22C3）TPS为60%。我们给予信迪利单抗联合安罗替尼治疗，即一种PD-1抑制剂联合抗血管生成药物。患者取得了良好疗效，不良反应可耐受。
信迪利单抗联合安罗替尼治疗可能为晚期肺肉瘤样癌患者带来良好疗效。
