Endostar plus pembrolizumab combined with a platinum-based dual chemotherapy regime for advanced pulmonary large-cell neuroendocrine carcinoma as a first-line treatment: A case report

Abstract

Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare and highly aggressive cancer with a very poor prognosis. The proper treatment decision and possible prognosis outcome for advanced LCNEC is always an enormous challenge due to its scarcity. Here, we presented a 59-year-old male patient with advanced LCNEC with a non-neuroendocrine immunophenotype who received endostar plus pembrolizumab combined with a platinum-based dual chemotherapy regime as a first-line treatment. At present, the patient’s condition is well controlled by medication only and has a progression-free survival of more than 2 years. Adverse effects recorded for this patient during treatment courses include nausea, vomiting, II–III quality bone marrow toxicity, and PD-1 blockage-related hypothyroidism. This case report discussed the feasibility of immunotherapy, anti-angiogenesis agents, and chemotherapy as a first-line therapy in advanced LCNEC.

Advances in genetic profile and therapeutic strategy of pulmonary large cell neuroendocrine carcinoma

“…Furthermore, Oda et al ( 59 ) reported a case of obtaining complete response (CR) for up to 4°years after treatment with pembrolizumab. According to the report of Zhang et al ( 60 ), pembrolizumab plus endostar was administered as first-line therapy for a patient diagnosed with LCNEC, the PFS was 2°years. Sherman et al ( 61 ) conducted a clinical trial in which a total of 37 patients with advanced LCNEC were enrolled, patients ( n = 21) who received anti-PD-1/PD-L1 immunotherapy demonstrated an ORR of 33%, a complete response rate (CRR) of 11%, a mPFS of 4.2°months (95% CI, 2.4−8.1), and a mOS of approximately 11.8°months (95% CI, 3.7-NR).…”

“…The 12-month survival rate was 34.0% versus 24.1%, while the 18-month survival rate stood at 29.1% versus 15.0% in the patients treated with or without immunotherapy. Furthermore, Oda et al (59) reported a case of obtaining complete response (CR) for up to 4 • years after treatment with pembrolizumab. According to the report of Zhang et al (60), pembrolizumab plus endostar was administered as first-line therapy for a patient diagnosed with LCNEC, the PFS was 2 • years.…”