Anlotinib combined with chemotherapy and immunotherapy for advanced pulmonary sarcomatoid cancer: A case report and literature review

Piao, Mei-Na and Ma, Xiao-Ting and Tankere, Pierre and Liam, Chong Kin and Li, Jin-Li and Wang, Jian-Ping (2022) Anlotinib combined with chemotherapy and immunotherapy for advanced pulmonary sarcomatoid cancer: A case report and literature review. Annals of Translational Medicine, 10 (18). ISSN 2305-5839, DOI https://doi.org/10.21037/atm-22-4312.

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Abstract

Pulmonary sarcomatoid carcinoma (PSC) is a rare disease which is highly malignant with a poor prognosis. PSC is highly resistant to chemotherapy and radiotherapy and is prone to recurrence even after surgery. Most of what is known about PSC comes from limited single-center, retrospective studies. There is still no standard international clinical guideline for PSC. Limited case reports have shown that PSC patients with driver gene mutations and high programmed death-ligand 1 (PD-L1) expression have good responses to molecular targeted therapy and immune checkpoint inhibitor (ICI) immunotherapy, respectively. Therefore, current first-line chemotherapy, targeted therapy and immunotherapy play a leading role in the diagnosis and treatment of advanced PSC patients. Case Description: We report a 42-year-old male who was diagnosed with PSC stage IVB (T4N2M1)] and treated at our department (Department of Radiation Oncology, The Affiliated Hospital of Soochow University). The initial computed tomography (CT) scan of the chest showed a large mass (159 mm x 112 mm) which on needle biopsy showed sarcomatoid carcinoma histology. The patient received 8 cycles of abraxane plus cisplatin chemotherapy combined with anlotinib and immunotherapy, followed by immunotherapy and anlotinib for >1 year. Finally, the local tumor was well controlled, and no obvious drug-related adverse reactions were observed. The large lesions in the lung remained in complete response for >24 months. Conclusions: To our knowledge, this is the first reported case of an advanced PSC patient showing a good response to the treatment consisting of anlotinib combined with sintilimab and platinum-doublet chemotherapy. This case suggests that chemotherapy combined with antiangiogenic therapy and immunotherapy may benefit patients with advanced PSC. Long-term immunotherapy and anlotinib maintenance therapy has been safe and effective in our case. However, randomized controlled clinical studies are needed to confirm the efficacy and safety of these treatment options.

Item Type: Article
Funders: Minsheng Science and Technology Foundation of Suzhou [SYS2019037], Project of State Key Laboratory of Radiation Medicine and Protection, Soochow University [GZK1202002]
Uncontrolled Keywords: Pulmonary sarcomatoid carcinoma (PSC); Anlotinib; Immunotherapy; Chemotherapy; Case report
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 25 Sep 2023 07:51
Last Modified: 25 Sep 2023 07:51
URI: http://eprints.um.edu.my/id/eprint/40888

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