Large cell neuroendocrine carcinoma of the lung controlled for 4 years by a single administration of pembrolizumab: A case report. Issue 19 (5th September 2022)

• Record Type: Journal Article
• Authors: Watanabe, Masayuki; Matsumura, Yuki; Yamaguchi, Hikaru; Mine, Hayato; Takagi, Hironori; Ozaki, Yuki; Fukuhara, Mitsuro; Muto, Satoshi; Okabe, Naoyuki; Shio, Yutaka; Suzuki, Hiroyuki
• Is Part Of: Thoracic cancer. Volume 13:Issue 19(2022)
• Page Start: 2817
• Page End: 2822
• Publication Date: 2022-09-05
• Subjects: immune checkpoint inhibitor -- immune‐related adverse event -- large cell neuroendocrine carcinoma of the lung; Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.14615
• Languages: English
• ISSNs: 1759-7706

Abstract

Abstract: Large cell neuroendocrine carcinoma of the lung (LCNEC) is a rare and highly progressive tumor with a poor prognosis. Although immune checkpoint inhibitors have been approved for treatment of both small cell and non–small cell lung cancers, their role in the treatment of LCNEC is unclear. We describe a patient with postoperative recurrence of LCNEC who maintained complete remission for 4 years after a single administration of pembrolizumab. A 68‐year‐old Japanese man underwent thoracoscopic right lower lobectomy for LCNEC (pathological stage pT1bN0M0, stage IA2). Epidermal growth factor receptor and anaplastic lymphoma kinase were negative, and the programmed death ligand 1 expression rate in tumor cells was 5% (clone 22C3). Eight months later, the patient developed recurrence with mediastinal lymph node metastasis and pleural dissemination. Therefore, chemotherapy with cisplatin and etoposide was administered. However, relapse occurred 6 months later. Pembrolizumab was administered as second‐line chemotherapy, which was discontinued after first dose because of interstitial pneumonia 1 month later. Thereafter, however, both the lymph node metastasis and pleural dissemination disappeared and did not relapse for 4 years. Pembrolizumab may be used as a treatment option for pulmonary LCNEC. Abstract : Clinical course of the patient. A 68‐year‐old Japanese man underwent curative resection for large cell neuroendocrine carcinoma of the lung in 2016. The tumor recurred 6 months later and lymph node metastasis and pleural dissemination persisted despite cytotoxic chemotherapy. Pembrolizumab was administered as second‐line chemotherapy, which was discontinued after first single dose because of interstitial pneumonia. Thereafter, however, both the lymph node metastasis and pleural dissemination disappeared and have not relapsed for 4 years.