Long-term Complete Response in a Patient with Disseminated Pulmonary Pleomorphic Carcinoma Induced by Cisplatin and Gemcitabine

Tamiya, Akihiro; Asami, Kazuhiro; Shimizu, Shigeki; Matsumura, Akira; Isa, Shun‐ichi; Okishio, Kyoichi; Kitaichi, Masanori; Atagi, Shinji; Takada, Minoru; Kawaguchi, Tomoya; Kubo, Akihito

doi:10.2169/internalmedicine.53.2637

Cited by 4 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several recent reports have described cases of PPC that responded to cytotoxic chemotherapy containing platinum and gemcitabine [ 8 – 12 , 23 ]. Tamiya et al mentioned that high expression of human equilibrative nucleoside transporter 1 (hENT1), the major transporter of gemcitabine, might be associated with high sensitivity to gemcitabine in PPC [ 12 ]. We also experienced one patient who achieved long-term stable disease without progression after receiving cisplatin and gemcitabine treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Although clinical outcome is stage-dependent, it follows a more aggressive clinical course and has a worse prognosis than other histological types of NSCLC [ 6 – 10 ]. Furthermore, some recent reports have noted that PPC is often refractory to chemotherapy regimens which provide active treatment for NSCLC [ 8 – 12 ]. Due to its rarity, no optimal treatment for PPC has yet been established.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Retrospective analysis of the efficacy of chemotherapy and molecular targeted therapy for advanced pulmonary pleomorphic carcinoma

Tamura

Fujiwara²,

Yamamoto³

et al. 2015

BMC Res Notes

View full text Add to dashboard Cite

BackgroundPulmonary pleomorphic carcinoma (PPC) follows an aggressive clinical course and outcomes are disappointing. Due to its rarity, however, the clinicopathological and molecular characteristics of this disease remain unclear.MethodsWe retrospectively evaluated the efficacy of chemotherapy and molecular targeted therapy in 16 patients with PPC who received chemotherapy or EGFR-TKI. We also investigated the status of EGFR mutation, KRAS mutation and ALK expression.ResultsOn histologic review of the malignant epithelial component, adenocarcinoma was identified in seven cases (43.8 %), large cell carcinoma in four (25.0 %), and squamous cell carcinoma in two (12.5 %). For the sarcomatoid component, 14 cases (87.5 %) had both spindle cell tumor and giant cell and 2 (12.5 %) had giant cell. Eleven patients received cytotoxic chemotherapy as first-line but did not achieve an objective response, although one patient who received docetaxel as second-line achieved a partial response. We also found that one patient achieved long stable disease of about 9 years without progression after receiving cisplatin and gemcitabine treatment. EGFR mutation, KRAS mutation and ALK expression were investigated in 14 patients whose tumor specimens were available. EGFR mutation was observed in 2 (14.3 %) and KRAS mutation in 3 (21.4 %), while no patient was positive for ALK expression. One patient harboring EGFR exon 19 deletion was treated with gefitinib after postoperative recurrence and achieved a complete response of about 35 months.ConclusionsAlthough advanced PPC showed a poor response to chemotherapy, one patient with EGFR mutation achieved an extended complete response. We therefore recommend the evaluation of driver gene alteration such as EGFR in the treatment of advanced PPC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of the efficacy of chemotherapy and molecular targeted therapy for advanced pulmonary pleomorphic carcinoma

Tamura

Fujiwara²,

Yamamoto³

et al. 2015

BMC Res Notes

View full text Add to dashboard Cite

show abstract

“…Kato et al resported cisplatin and vinorelbine were effective as a neo-adjuvant therapy for PPC patients [ 29 ]. Some reports have mentioned that a regimen involving gemcitabine or taxanes is effective [ 12 , 30 , 31 ]. In our study, we found that patients who received chemotherapy had better OS than patients without chemotherapy and chemotherapy were found to be independently associated with the survival, especially in the distant stage.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics, survival outcomes and prognostic factors in pleomorphic carcinoma: a SEER population-based study

2022

View full text Add to dashboard Cite

Background Pulmonary pleomorphic carcinoma (PPC) is a rare tumor, and it usually has an aggressive clinical course and poor prognosis. We aim to analyze the clinicopathological features, management and prognostic factors of pulmonary pleomorphic carcinoma. Patients and methods Using the surveillance, epidemiology, and end results (SEER) database, we identified 461 patients of pulmonary pleomorphic carcinoma from 2004 to 2014 including clinicopathological characteristics, treatment modalities and outcome data. Results The mean age of all PPC patients was 66 years and 58% of the patients were male. Most patients (80%) were white people, 53% were found in the right lung, and lesions were mostly observed in upper lobe (56%). The median overall survival was 9 months and overall 1-, 3- and 5-year survival rate was 45%, 29%, 23%. In Kaplan–Meier analysis, age, marital status, tumor primary site, gender, laterality, SEER summary stage, chemotherapy and surgery were associated with overall survival. Patients received surgery or chemotherapy had a better OS for patients with PPC. Multivariate Cox analysis revealed that SEER summary stage, age, surgery and chemotherapy were found to be independently associated with the OS. Surgery could significantly prolong survival in patients with localized stage and regional stage (HR = 0.120, 95% CI 0.038–0.383, p < 0.001; HR = 0.351, 95% CI 0.212–0.582, p < 0.001) while it did not have great impact on survival in patients with distant stage (p = 0.192). Chemotherapy decreased risk of death by 46% (HR = 0.544, 95% CI 0.393–0.752, p < 0.001) for patients with distant stage, whereas chemotherapy did not confer survival benefits to patients with localized stage and regional stage. But radiation did not have great impact on survival of patients with different stages in this study. Conclusions PPC mostly occurred in white people, with a median age of 66 years, and men were more susceptible to this disease. The SEER summary stage, age, surgery and chemotherapy were independently associated with prognosis. Surgery should be considered for the PPC patients with localized stage or regional stage, and chemotherapy should be recommended for the treatment of patients with distant stage.

show abstract

“…Similarly, some PPC cases treated with cytotoxic chemotherapy have been reported, but the median OS was only 7–8 months. Some reports have mentioned that a regimen involving gemcitabine or taxanes is effective. Tamura et al .…”

Section: Discussionmentioning

confidence: 99%

Long‐term response with durvalumab after chemoradiotherapy for pulmonary pleomorphic carcinoma: A case report

Yorozuya

Taya

et al. 2020

Thoracic Cancer

View full text Add to dashboard Cite

Pulmonary pleomorphic carcinoma (PPC) is a non-small-cell lung cancer, resistant to chemotherapy and no standard therapy has as yet been established. We herein report the case of a 59-year-old man with PPC who showed a longterm response with durvalumab after chemoradiotherapy. He was referred to our hospital with a mass shadow at the right upper lung. PPC clinical stage IIIB was diagnosed, and the tumor proportion score of programmed death-ligand 1 (PD-L1) was 100%. Six days after transbronchial biopsy, he had difficulty walking owing to sensory abnormalities. We found that the primary tumor had invaded the spinal cord and compressed the cord at T1-T4, resulting in the abnormalities. He underwent tumor resection and received chemotherapy involving cisplatin (CDDP) + S-1 and concurrent radiotherapy (66 Gy). Subsequently, durvalumab treatment as consolidation therapy was commenced. After one year of durvalumab treatment had been completed, he had no apparent signs of relapse or severe adverse events. This case suggests that a long-term response can be achieved with durvalumab after chemoradiotherapy for stage III inoperable PPC showing high PD-L1 expression. Key PointsSignificant findings of the report A long-term response might be achieved with durvalumab after chemoradiotherapy in patients with stage III inoperable pulmonary pleomorphic carcinoma showing high expression of programmed death-ligand 1. What this study adds It is possible to continue durvalumab treatment for one year without any severe adverse events. Although pulmonary pleomorphic carcinoma is considered to have a poor prognosis, the combination therapy of immune checkpoint inhibitors and radiotherapy may be an effective treatment option.

show abstract

Long-term Complete Response in a Patient with Disseminated Pulmonary Pleomorphic Carcinoma Induced by Cisplatin and Gemcitabine

Cited by 4 publications

References 12 publications

Retrospective analysis of the efficacy of chemotherapy and molecular targeted therapy for advanced pulmonary pleomorphic carcinoma

Retrospective analysis of the efficacy of chemotherapy and molecular targeted therapy for advanced pulmonary pleomorphic carcinoma

Clinicopathological characteristics, survival outcomes and prognostic factors in pleomorphic carcinoma: a SEER population-based study

Long‐term response with durvalumab after chemoradiotherapy for pulmonary pleomorphic carcinoma: A case report

Contact Info

Product

Resources

About