Strong Response to Pembrolizumab-Based Therapy for Pleomorphic Lung Cancer

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage III
Biomarkers
EGFR-negative; ALK-negative; ROS1-negative; PD-L1 TPS 90%-100%.
Sex
Male
Treatment
chemotherapy, immunotherapy and supportive care
Outcome
Responding Well

Treatment course, step by step

  1. Antibiotics were given for obstructive pneumonia.
  2. A surgical biopsy confirmed pleomorphic carcinoma.
  3. Four cycles of pembrolizumab, carboplatin, and nab-paclitaxel were administered.
  4. Maintenance pembrolizumab continued after the combination produced marked tumor shrinkage.

What happened, in summary

A 66-year-old man was admitted to a local hospital with wheezing and shortness of breath. CT showed obstructive pneumonia caused by a tumor in the left lung. Antibiotics were given, and a surgical biopsy established pleomorphic carcinoma. The cancer was staged cT4N2M0, stage IIIA.

Molecular testing found no EGFR, ALK, or ROS1 driver alteration. PD-L1 expression was very high, with a tumor proportion score of 90% to 100%. His performance status was good, and systemic treatment combined pembrolizumab with carboplatin and nab-paclitaxel.

Early follow-up already showed tumor shrinkage. He transferred to the reporting hospital to continue treatment and completed four cycles of the three-drug combination. Imaging then demonstrated a marked response. Pembrolizumab was continued as maintenance therapy after chemotherapy ended.

Seven months after treatment began, maintenance pembrolizumab was still ongoing. Unlike another patient in the same series who received pembrolizumab alone without benefit, this patient had a strong and durable early response to combined immunotherapy and chemotherapy. Maintenance treatment remained active at the last documented follow-up.

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

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