Pulmonary pleomorphic carcinoma treated with immune checkpoint inhibitors — a case series
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Abstract
Pulmonary pleomorphic carcinoma (PPC) is a rare subtype of primary lung cancer, accounting for less than 2% of annual diagnoses. It is characterized by a low response rate to systemic treatment, an unusual molecular profile, an average high tumor mutation burden score, and poor prognosis. This article presents four cases of patients with PPC treated with immune checkpoint inhibitors.
Two patients were women diagnosed with spindle cell carcinoma, while the other two were men diagnosed with pleomorphic carcinoma. The mean age was 68.75 years, and the clinical stage varied between II and IV. Two patients received immunotherapy as a second-line treatment, while the other two received it as a first-line therapy. Most patients had a history of smoking, with half of the patients smoking during the treatment. Only one patient experienced disease progression during treatment, while three achieved partial response, and two patients maintained response for over 40 treatment cycles. The toxicity of the treatment in patients reached up to grade 3 according to the Common Terminology Criteria for Adverse Events, and involving multiple sites.
Given the highly specific molecular landscape and the promising results observed in the majority of patients, immunotherapy appears to be a favorable viable treatment option for the management of this rare neoplasm.
Keywords: non-small cell lung carcinomapulmonary pleomorphic carcinomaimmunotherapyimmune checkpoint inhibitorsnivolumabpembrolizumab
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