Anlotinib combined with pembrolizumab as first-line treatment for advanced pulmonary sarcomatoid carcinoma: a case report and literature review

Frontiers in Oncology

Oncology

Lina Yi¹  Qingqing Li¹  Yi Dong¹  Chen Zhao¹  Dafu Ye¹  Yingmei Wen¹  Mengxia Xiao²  Yi Yao³  Guifang Yang⁴ 

[1] Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China;Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China;Department of Oncology, Yichun People’s Hospital, Yichun, China;Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China;Hubei Provincial Research Center for Precision Medicine of Cancer, Wuhan, China;Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China;

关键词: pulmonary sarcomatoid carcinoma;    anlotinib;    pembrolizumab;    immune checkpoint inhibitors;    genomic analysis;    case report;   

DOI  :  10.3389/fonc.2023.1241475

 received in 2023-06-16, accepted in 2023-10-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

Pulmonary sarcomatoid carcinoma (PSC) is an uncommon variant of non-small cell lung cancer (NSCLC), known for its unfavorable prognosis. Previous studies have elucidated that PSC generally exhibits a significant expression of programmed death-ligand 1 (PD-L1), an elevated tumor mutation burden, and marked vascular invasion. These factors imply the possible effectiveness of treatments like immunotherapy and anti-angiogenic therapy. The subject of this case was a 65-year-old male diagnosed with advanced PSC, characterized by high PD-L1 expression and devoid of known driver gene mutations. Owing to the restrictions imposed by the COVID-19 pandemic, the patient initially underwent home-based treatment with anlotinib, which led to symptomatic improvement after a single treatment cycle. Subsequent hospitalization allowed for the administration of anlotinib plus Pembrolizumab, resulting in a partial response. Radiotherapy was necessitated due to local disease progression. But after 15 cycles of treatment with Pembrolizumab, hyperprogression was observed. The patient’s overall survival spanned 14 months, with no evident adverse reactions to the medications. Genomic analysis revealed potential associations between treatment efficacy and mutations in the TP53, NF1, and MET genes. This case underscores the effectiveness and safety of a first-line treatment regimen combining pan-target anti-angiogenic therapy (anlotinib) with anti-tumor immunotherapy.

【 授权许可】

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Copyright © 2023 Wen, Dong, Yi, Yang, Xiao, Li, Zhao, Ye and Yao