Stage III Pulmonary Sarcomatoid Carcinoma With Major Response and No Recurrence

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage III
Biomarkers
NRAS mutation; TP53 mutation; PD-L1 TPS 60%
Sex
male
Treatment
chemotherapy, immunotherapy and surgery
Outcome
Cancer-Free / NED

Treatment course, step by step

  1. Received 4 cycles of tislelizumab with albumin-bound paclitaxel and cisplatin, producing a partial response.
  2. Underwent right upper lobectomy with systematic lymph-node dissection and had about 10% residual tumor.
  3. Received 13 cycles of immunotherapy after surgery.

What happened, in summary

A 56-year-old man sought care in March 2022 after 3 months of persistent dry cough. CT showed a very large tumor in the right upper lung together with enlarged hilar and mediastinal lymph nodes. Biopsy showed a malignant spindle-cell tumor consistent with pulmonary sarcomatoid carcinoma. The cancer was Stage III.

Tumor testing found NRAS and TP53 mutations, and PD-L1 expression was high at 60%. He received 4 cycles of tislelizumab combined with albumin-bound paclitaxel and cisplatin. Follow-up imaging showed substantial shrinkage of both the lung tumor and lymph nodes, representing a partial response.

In July 2022, he underwent right upper lobectomy with systematic lymph-node dissection. Pathology showed a major response to treatment, with only about 10% residual tumor and no active cancer found in the sampled lymph nodes.

He continued immunotherapy for 13 cycles after surgery. During follow-up, no recurrence was detected for more than 27 months. His course illustrates a strong response to neoadjuvant immunochemotherapy despite the aggressive histology of pulmonary sarcomatoid carcinoma.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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