What happened, in summary

A 65-year-old man developed cough and coughing up blood and was evaluated in March 2022. CT showed a right lower-lung tumor obstructing the lower-lobe bronchus together with an enlarged mediastinal lymph node. Biopsy showed a malignant spindle-cell tumor consistent with pulmonary sarcomatoid carcinoma, classified as Stage III.

Tumor testing found a TP53 mutation, and PD-L1 expression was 40%. He received 2 cycles of sintilimab combined with albumin-bound paclitaxel and cisplatin. Follow-up imaging showed that the lung mass and mediastinal node had shrunk substantially, representing a partial response.

In June 2022, he underwent right lower lobectomy with systematic lymph-node dissection. Pathology showed residual pulmonary sarcomatoid carcinoma involving about 30% of the treated tumor area. Several sampled nodes were negative, although cancer remained in station 7 nodes.

He received 2 more cycles of immunotherapy plus platinum-based chemotherapy after surgery. During postoperative follow-up, no recurrence was detected for more than 30 months.