Case report: Pathological complete response induced by immunochemotherapy in a case of Pulmonary Sarcomatoid Carcinoma staged IIIA-N2

Front Immunol. 2024 Apr 8:15:1374270. doi: 10.3389/fimmu.2024.1374270. eCollection 2024.

Abstract

Pulmonary sarcomatoid carcinoma (PSC) represents a rare and highly aggressive variant of lung cancer, characterized by its recalcitrance to conventional therapeutic modalities and the attendant dismal prognosis it confers. Recent breakthroughs in immunotherapy have presented novel prospects for PSC patients; nevertheless, the utility of neoadjuvant/conversional immunotherapy in the context of PSC remains ambiguous. In this report, we present a middle-aged male presenting with Stage III PSC, notable for its high expression of the programmed death-ligand 1 (PD-L1), initially deemed as non-resectable for sizeable tumor mass and multiple lymph nodes metastases. The patient underwent a transformation to a resectable state after a regimen of three cycles of platinum-based chemotherapy plus immunotherapy. Following definitive surgical resection, the individual realized a pathological complete response (pCR), culminating in a significant prolongation of event-free survival (EFS). This case underscores the viability of employing immunochemotherapy as a neoadjuvant/conversional strategy for chosen cases of PSC.

Keywords: conversional therapy; immunochemotherapy; immunotherapy; neoadjuvant therapy; pathological complete response; pulmonary sarcomatoid carcinoma.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • B7-H1 Antigen / antagonists & inhibitors
  • Carcinosarcoma / drug therapy
  • Carcinosarcoma / pathology
  • Carcinosarcoma / therapy
  • Humans
  • Immunotherapy / methods
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / therapy
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods
  • Neoplasm Staging
  • Treatment Outcome

Substances

  • B7-H1 Antigen

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Department of Science and Technology of Hunan Province (NO.S2020SFYLJS0412), the Scientific Research Project of Hunan Provincial Health Commission (No.20231442), the Natural Science Foundation of Hunan Province (No. 2023JJ40837, No.2022JJ40704), and the Scientific Research Launch Project for new employees of the Second Xiangya Hospital of Central South University.