Atezolizumab in combination with carboplatin plus nab‐paclitaxel for managing combined large‐cell neuroendocrine carcinoma: A case report

Tsutsumi, Rei; Kataoka, Nobutaka; Kunimatsu, Yusuke; Sato, Izumi; Tanimura, Mai; Nakano, Takayuki; Tanimura, Keiko; Takeda, Takayuki

doi:10.1002/rcr2.989

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…The median OS was found to be significantly longer in p-LCNEC compared to c-LCNEC. However, Tsutsumi et al ( 29 ) reported that a 73-year-old c-LCNEC patient with brain metastases achieved PR after receiving atezolizumab combined with carboplatin and nab-paclitaxel, which was maintained for 12 months. Xu et al ( 30 ) reported a 54-year-old locally advanced c-LCNEC patient who was maintained with durvalumab after concurrent radiotherapy and chemotherapy, who achieved complete remission.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of immune checkpoint inhibitors in lung large-cell neuroendocrine carcinoma

Shi,

Wei,

et al. 2023

J Thorac Dis

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Background Lung large-cell neuroendocrine carcinoma (L-LCNEC) is a rare and highly aggressive neuroendocrine tumor. There is currently no standard therapeutic regimen, and systemic chemotherapy results in poor prognosis. Due to the rarity of L-LCNEC, the efficacy and safety of immune checkpoint inhibitors (ICIs) remain unclear. Methods This study included 34 L-LCNEC patients administered ICIs at Zhejiang Cancer Hospital, from February 6, 2018 to February 6, 2023. The treatment responses were evaluated. Fisher’s exact test was used to compare categorical variables, and the Kaplan-Meier method was used for survival analyses. Cox regression was used for multivariate analysis. Results The objective response rate (ORR) of 34 patients was 29.4%, the disease control rate (DCR) was 82.4%, the median progression-free survival (PFS) was 6.30 months, and the median overall survival (OS) was 14.77 months. The ORRs of combined LCNEC (n=7) and pure LCNEC (n=27) were 14.3% and 33.3%; the DCRs were 100% and 77.8%; the median PFSs were 12.48 and 5.6 months (P=0.032); and the median OSs were 21.27 and 14.73 months, respectively (P=0.233). The observed incidence of immune-related adverse events (irAEs) was 61.8%, primarily occurring in grades 1/2 (58.8%) and grade 3 (5.9%). Elevated aminotransferases (14.7%), pneumonia (8.8%), and fatigue (8.8%) were the most common irAEs. Conclusions ICIs treatment showed efficacy and safety in advanced L-LCNEC, with the potential for greater benefits in the combined LCNEC subtype.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of immune checkpoint inhibitors in lung large-cell neuroendocrine carcinoma

Shi,

Wei,

et al. 2023

J Thorac Dis

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“…Adenocarcinoma is the most common mixed component of CLCNEC accounting for around 70%, followed by squamous cell carcinoma representing 20% of CLCNEC [ 12 , 13 ]. Sarcomatoid was reported as a combined component in a case report recently [ 29 ].…”

Section: Diagnosis and Pathological Featuresmentioning

confidence: 99%

“…A 73-year-old male with CLCNEC of the lung containing adenocarcinoma and sarcomatoid components was treated with chemotherapy consisting of carboplatin and nanoparticle albumin-bound (nab)-paclitaxel plus atezolizumab, which was decided in accordance with the histological evaluation of the components. This treatment resulted in partial response (PR) and remained durable for 12 months [ 29 ]. The aforementioned finding indicated that some CLCNEC patients may benefit from immunotherapy due to high TMB, but more clinical data are needed to support this statement and can assist in highlighting the standardized treatment method for CLCNEC.…”

Section: Potential Future Opportunitiesmentioning

confidence: 99%

Pulmonary Combined Large Cell Neuroendocrine Carcinoma

Li¹,

Yang²,

Lu³

2022

Pathol. Oncol. Res.

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Pulmonary combined large-cell neuroendocrine carcinoma (CLCNEC) is a rare neuroendocrine tumor pertained to lung large cell neuroendocrine carcinoma (LCNEC) with aggressive behavior and poor prognosis generally. The clinical features of CLCNEC are not specific including cough, expectoration, chest distress, chest pain, etc., which are prone to have different manifestations of the mixed components. Owing to the low incidence, there are few related small-scale retrospective studies and case reports. Currently, the treatment regimen of CLCNEC mainly refers to LCNEC that complete surgical resection is preferred in the early stage and according to previous researches, platinum-based small cell lung cancer (SCLC) standard treatment regimen showed promising results in postoperative and advanced CLCNEC as compared to that of non-small cell lung cancer (NSCLC). Adenocarcinoma-CLCNEC more likely harbor driver gene mutation, and may benefit from targeted therapy. As for immunotherapy, more clinical trial data are needed to support its benefits. This article will fill the gap and will provide new insight into the clinical characteristics, pathological diagnosis and treatment endeavors of CLCNEC.

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Atezolizumab in combination with carboplatin plus nab‐paclitaxel for managing combined large‐cell neuroendocrine carcinoma: A case report

Tsutsumi

Kataoka

Kunimatsu

et al. 2022

Respirology Case Reports

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Large‐cell neuroendocrine carcinomas (LCNECs), categorized as high‐grade neuroendocrine carcinomas, account for approximately 3% of resected lung cancers. LCNECs containing other components are called ‘combined LCNECs’ and have no standard treatment. A 73‐year‐old male with a metastatic brain tumour from a combined LCNEC of the lung containing adenocarcinoma and sarcomatoid components was referred to our department. The patient was treated with chemotherapy consisting of carboplatin and nanoparticle albumin‐bound (nab)‐paclitaxel in combination with atezolizumab, which was decided in accordance with the histological evaluation of the components. This treatment resulted in partial response and remained durable for 12 months with an ongoing regimen. The current case suggests that the constituents of chemoimmunotherapy should be selected in accordance with the reported efficacy of relevant regimens for each component of the combined LCNEC.

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Atezolizumab in combination with carboplatin plus nab‐paclitaxel for managing combined large‐cell neuroendocrine carcinoma: A case report

Cited by 3 publications

References 6 publications

Efficacy and safety of immune checkpoint inhibitors in lung large-cell neuroendocrine carcinoma

Efficacy and safety of immune checkpoint inhibitors in lung large-cell neuroendocrine carcinoma

Pulmonary Combined Large Cell Neuroendocrine Carcinoma

Atezolizumab in combination with carboplatin plus nab‐paclitaxel for managing combined large‐cell neuroendocrine carcinoma: A case report

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