The role of palliative chemotherapy for advanced pulmonary pleomorphic carcinoma

Hong, Jung Yong; Choi, Moon Ki; Uhm, Jieun; Park, Min Jae; Lee, Jeeyun; Park, Yeon Hee; Ahn, Jin Seok; Park, Keunchil; Han, Joung Ho; Ahn, Myung Ju

doi:10.1007/s12032-008-9117-4

Cited by 54 publications

(47 citation statements)

References 12 publications

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“…Of the 12 patients, 3 survived for 1 year and were treated with TKIs as third-line therapy, although the epidermal growth factor receptor (EGFR) mutation status was not described in these patients. Interestingly, 1 of the 3 patients was treated with pemetrexed as second-line chemotherapy (11). In the present study, we demonstrated a sustained response for 30 months in 1 patient and stable disease for 6 months without deterioration of the general condition in another patient treated with pemetrexed-containing chemotherapy.…”

Section: Discussionsupporting

confidence: 60%

“…The median overall survival (OS) of their 11 patients who did not receive palliative chemotherapy for advanced pulmonary pleomorphic carcinoma was only 2 months, compared with 8 months for the patients who received palliative chemotherapy (8). Hong et al reported the role of palliative chemotherapy for 12 patients with advanced pulmonary pleomorphic carcinoma (11) and demonstrated that the median OS from the day of initiation of first-line chemotherapy was 8 months (11). Of the 12 patients, 3 survived for 1 year and were treated with TKIs as third-line therapy, although the epidermal growth factor receptor (EGFR) mutation status was not described in these patients.…”

Section: Discussionmentioning

confidence: 99%

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Pemetrexed and bevacizumab-containing chemotherapy for pleomorphic carcinoma of the lung

Tamura

Ohara

Kagohashi

et al. 2016

Molecular and Clinical Oncology

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Abstract. Pleomorphic carcinoma of the lung is a rare, highly malignant subtype of lung cancer, with a more aggressive clinical course compared with other types of non-small-cell lung cancer (NSCLC). Pemetrexed and bevacizumab are currently evaluated as two of the most reliable chemotherapeutic drugs for advanced NSCLC. We herein report a case of a 68-and a 46-year-old man with recurrent and chemo-naïve pleomorphic carcinoma of the lung, respectively, who were treated with a combination of carboplatin, pemetrexed and bevacizumab. The overall survival after the initiation of chemotherapy was 30 and 8 months, respectively. These cases exhibited a relatively long-term survival with chemotherapy. In the absence of definitive clinical trials, which are unlikely to be performed due to the rarity of this tumor, our cases demonstrated the potential utility of pemetrexed-and bevacizumab-containing chemotherapy. Our results also suggested that pemetrexed-containing chemotherapy may be key to the treatment of pleomorphic carcinoma of the lung.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Pemetrexed and bevacizumab-containing chemotherapy for pleomorphic carcinoma of the lung

Tamura

Ohara

Kagohashi

et al. 2016

Molecular and Clinical Oncology

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“…There are few studies with regard to the chemotherapy of PPC, and its clinical and pathological characteristics therefore remain unclear. In patients with advanced or relapsed PPC, the response rate to chemotherapy regimens that are known to be effective in patients with NSCLC is only 0-17% (2,9). A previous study reported the cases of two patients with advanced PPC who showed a partial remission to chemotherapy with doxorubicin, ifosfamide and dacarbazine.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of two consecutive cases of pulmonary pleomorphic carcinoma with platinum chemotherapy

et al. 2015

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Abstract. Pulmonary pleomorphic carcinoma (PPC) is a rare pulmonary malignant tumor that has a more aggressive clinical course and a poorer prognosis compared with non-small cell lung cancer (NSCLC) due to its resistance to chemotherapy and radiotherapy. In patients with advanced or relapsed PPC, it has been reported that the response rate to chemotherapy regimens known to be effective in patients with NSCLC is only 0-17%. The present study reports the cases of two consecutive patients with advanced PPC who exhibited marked responses to chemotherapy with carboplatin plus paclitaxel chemotherapy and long-term survival without tumor progression. This suggests that carboplatin plus paclitaxel chemotherapy is a good option for the treatment of advanced PPC. IntroductionPulmonary pleomorphic carcinoma (PPC) is a rare primary malignant tumor in which carcinomatous and sarcomatous elements occur. The occurrence of the disease is extremely rare, accounting for only 0.1-0.4% of all reported malignant lung tumors (1-4). Patients with PPC are reported to be predominantly male smokers with a mean age of 66 years (5-8). PPC generally exhibits an aggressive clinical course, and has a tendency to grow rapidly and invade adjacent structures in the early stage. The recurrence after surgical treatment is common, and systemic metastases are frequently observed in patients with PPC (8). The prognosis of PPC is significantly worse than the majority of other subsets of non-small cell lung cancer (NSCLC) due to its poorer response to chemotherapy and radiotherapy. The response rate to chemotherapy regimens commonly used for NSCLC is in the range of 0-17% (2,9) and the median survival reported for patients with PPC was 5-10 months (1,2,9). The present study reports two cases of advanced PPC that were successfully treated with carboplatin plus paclitaxel chemotherapy and/or radiotherapy. Case reportCase 1. A 66-year-old male was admitted to the Otsu Red Cross Hospital (Otsu, Shiga, Japan) in May 2013, due to a persistent cough and dyspnea that had persisted for 10 days. The patient had previously undergone a surgical resection of the colon due to a gastrointestinal stromal tumor. The patient had also smoked two packs of cigarettes per day for 37 years. A performance status score of 1, according to the Eastern Cooperative Oncology Group (ECOG) scale (10), was recorded. Computed tomography (CT) of the chest showed a large tumor, measuring 100x80 mm, in the right lower lobe of the lung, with pleural effusion. An ultrasonography-guided percutaneous lung biopsy was performed, and the tumor specimen consisted of epithelioid and sarcomatous cells (Fig. 1A). On immunohistochemical staining, pankeratin was diffusely positive in the epithelioid and sarcomatous components (Fig. 1B). The patient was diagnosed with PPC based on the morphological findings of the tumor cells admixed with sarcomatoid and epithelioid cells. There was no evidence of metastasis to the other organs, corresponding to a diagnosis of clinical stage Ⅳ (cT4N0M1a) in the TNM cla...

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“…The pathological characteristics of the surgical specimen revealed intratumoral hemorrhaging and necrotic changes, with a very high MIB-1 proliferation index, all of which indicated the aggressive clini- cal nature of the tumor. While pleomorphic carcinoma has been deemed a tumor with a poor prognosis, several reports have described pleomorphic carcinomas that responded to cytotoxic chemotherapy containing platinum plus gemcitabine (7)(8)(9)(10). For example, Hong et al reported two cases of PR and two cases of stable disease among eight patients with pleomorphic carcinoma treated with platinum plus gemcitabine (11).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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A 47-year-old man was referred to our department due to multiple metastases in the lungs and liver with pleural dissemination six weeks after undergoing curative surgery for lung pleomorphic carcinoma. He received two regimens of chemotherapy, both of which resulted in disease progression. Considering his good general condition, he was treated with cisplatin plus gemcitabine (GP). The metastatic lesions exhibited a complete response after six courses of GP, and the patient has remained free from recurrence for over six years. An immunohistochemical analysis revealed that the tumor was highly expressive of gemcitabine transporter human equilibrative nucleoside transporter 1, thus suggesting a high sensitivity to gemcitabine.

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The role of palliative chemotherapy for advanced pulmonary pleomorphic carcinoma

Cited by 54 publications

References 12 publications

Pemetrexed and bevacizumab-containing chemotherapy for pleomorphic carcinoma of the lung

Pemetrexed and bevacizumab-containing chemotherapy for pleomorphic carcinoma of the lung

Successful treatment of two consecutive cases of pulmonary pleomorphic carcinoma with platinum chemotherapy

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

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