Stage IV Large-Cell Neuroendocrine Lung Cancer Controlled for Nearly Four Years With Multiple Treatments

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Non-Small Cell Lung Cancer
Biomarkers
PD-L1 high (TPS 50%) initially; no actionable driver mutation; later PD-L1 5%
Sex
female
Spread to
liver, bones
Treatment
chemotherapy, immunotherapy, targeted therapy, radiation and palliative care
Outcome
In Memory

Treatment course, step by step

  1. Started platinum-based chemotherapy with camrelizumab and anti-angiogenic therapy and achieved a partial response after 6 cycles.
  2. Continued maintenance immunotherapy and anti-angiogenic treatment and received palliative radiation for local progression.
  3. After liver progression, resumed the initial combination with liver-directed therapy and again achieved a partial response.
  4. Later received additional chemotherapy, immunotherapy and anti-angiogenic combinations as the cancer progressed.
  5. After brief later chemotherapy, transitioned to hospice care.

What happened, in summary

A 45-year-old woman was diagnosed in early 2021 with Stage IV pulmonary large-cell neuroendocrine carcinoma involving the liver and bones. Molecular testing showed high PD-L1 expression at 50% and several genetic alterations, but no actionable driver mutation.

She began a four-drug combination of camrelizumab, endostar, etoposide, and cisplatin and achieved a partial response after 6 cycles. Maintenance immunotherapy and anti-angiogenic treatment followed. When local disease progressed, she received palliative radiation, and later liver progression was treated by restarting the original combination together with liver-directed therapy. She again had a partial response.

Further progression led to several additional regimens, including atezolizumab with bevacizumab and docetaxel, followed by atezolizumab with pemetrexed and anlotinib. After later progression and brief additional chemotherapy, she could not tolerate more treatment and entered hospice. She died on December 13, 2024. Her overall survival reached 47 months, during which several treatment combinations produced periods of disease control.

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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