<p>Pulmonary Lymphoepithelioma-Like Carcinoma: A Mini-Review</p>

Abstract

Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare and distinct subtype of non-small-cell lung carcinoma associated with Epstein-Barr virus (EBV) infection. We systematically reviewed the recent research that expands our knowledge about PLELC, with main focus on its genetic profile, tumor-infiltrating environment, PD-L1 expression, circulating EBV-DNA, clinical utility of 18F-FDG PET/CT, and treatment strategy. A low frequency of typical driver mutations and widespread existence of copy number variations was detected in PLELC. Persistent EBV infection may trigger intense infiltration of lymphocytes, representing enhanced tumor immunity and possibly resulting in a better prognosis. Circulating EBV-DNA in the plasma of patients with PLELC may predict disease progression and response to therapy. PLELC is 18F-FDG avid, and 18F-FDG PET may help refine palliation strategies and subsequently improve the prognosis. Most of the reported patients present at early and resectable stage, and surgical resection with curative intent is the preferred approach. There is currently no consensus on the regimen of chemotherapy for patients with advanced stages. EGFR-targeted therapies seem to have no therapeutic effect, and the clinical impact of PD-1/PD-L1 therapy is uncertain but worthy of further research.

A Rare Subtype of Non-small Cell Lung Cancer: Report of 159 Resected Pathological Stage I–IIIA Pulmonary Lymphoepithelioma-Like Carcinoma Cases

“…The same scenarios were also observed in Wang et al's study (29) and Chang et al's study (30). The results above indicated that typical driver gene mutations, the main etiology of other common NSCLCs, might not play a critical role in the carcinogenesis of LELC (31). Furthermore, EGFR or ALK-targeted agents might not be suitable in the neoadjuvant or adjuvant therapy of advanced LELC.…”

A Rare Subtype of Non-small Cell Lung Cancer: Report of 159 Resected Pathological Stage I-IIIA Pulmonary Lymphoepithelioma-like Carcinoma Cases

“…The same scenarios were also observed in Wang et al's study [30] and Chang et al's study [31]. The results above indicated that typical driver gene mutations, the main etiology of other common NSCLCs, might not play a critical role in the carcinogenesis of LELC [32]. Furthermore, EGFR or ALK-targeted agents might not be suitable in the neoadjuvant or adjuvant therapy of advanced LELC.…”

Novel Multimodal Management of Post-Partum Synchronous Metastatic Pulmonary EBV-Associated Lymphoepithelioma-Like Carcinoma (LELC)—A Case Report

“…However, the oligoprogression of three of the bone metastases was confirmed approximately six months after the start of pembrolizumab maintenance. In addition, the prognostic value of circulating EBV-DNA in pulmonary LELC has been described in [11]. In the current case, the circulating EBV-DNA was not measured.…”