What happened, in summary

A 67-year-old man was evaluated in November 2023 after a small left upper-lung lesion was found during a physical examination. Surgery confirmed Stage I pulmonary pleomorphic carcinoma, a rare aggressive form of lung cancer. No driver mutation was detected.

Only 5 months after surgery, he developed cough and coughing up blood. Imaging showed a new mass at the surgical site and a metastasis in the third thoracic vertebra, establishing Stage IV recurrent disease. He underwent further lung surgery in May 2024. Testing of the recurrent tumor showed high PD-L1 expression at 80%.

After surgery, he received 6 cycles of albumin-paclitaxel and gemcitabine with the immunotherapy drug sintilimab and the anti-angiogenic drug bevacizumab. Denosumab was also given for the bone metastasis. The combination produced a partial response, confirmed on PET-CT in December 2024. As of February 2025, he was continuing maintenance sintilimab and bevacizumab, with about 9 months of progression-free survival after treatment for the recurrence.