Pulmonary sarcomatoid carcinoma presenting both ALK rearrangement and PD-L1 high positivity: A case report on the therapeutic regimen

Medicine
Federica D'AntonioArmando Santoro

Abstract

Pulmonary sarcomatoid carcinoma (PSC) represents <1% of all lung cancers and is characterized by a very poor prognosis. The optimal therapeutic regimen remains unclear. We describe a rare case of PSC with both anaplastic lymphoma kinase (ALK)-arranged and high levels of programmed death ligand 1 (PD-L1) expression. A 46-year-old woman, nonsmoker, came to our attention due to uncontrolled pain in the lower left limb. PSC with both ALK rearrangement and high levels of PD-L1 expression. The patient started first-line systemic treatment with pembrolizumab reporting stable disease; at progression, she received second-line treatment with crizotinib. The treatment was not well-tolerated, and the patient then underwent 5 cycles of ceritinib treatment. The patient showed a partial response to targeted therapy. At progression, brigatinib was initiated, but the patients reported liver progression soon after the initiation of this therapy. Molecular-driven investigation is necessary in PSC for treatment selection.

References

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Nov 28, 2012·Clinics and Research in Hepatology and Gastroenterology·Marie-Pierre RipaultDominique Larrey
May 23, 2015·Biochemical and Biophysical Research Communications·Kailong LinBo Zhu
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Mar 9, 2017·The Lancet Oncology·Lesley SeymourUNKNOWN RECIST working group

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Citations

Sep 15, 2020·Therapeutic Advances in Medical Oncology·Xin LiJun Chen

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Methods Mentioned

BETA
biopsies
Fluorescence

Software Mentioned

iRECIST

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