Neoadjuvant immunochemotherapy for pulmonary large-cell neuroendocrine carcinoma: case report

J Cardiothorac Surg. 2024 Apr 15;19(1):213. doi: 10.1186/s13019-024-02695-x.

Abstract

Background: Pulmonary large-cell neuroendocrine carcinoma (pLCNEC) represents a rare malignancy characterized by its aggressive behavior and a notably high recurrence rate. Remarkably, there is currently no established standard treatment protocol for this condition.

Case description: In this report, we present an intriguing case of pLCNEC diagnosed at clinical-stage IIB. This case involves a 64-year-old man with a smoking history spanning four decades. In our approach, we initiated a course of neoadjuvant chemotherapy in combination with pembrolizumab, administered for two cycles prior to surgical resection. This innovative treatment strategy resulted in a significant pathological response, culminating in a major pathological remission (MPR). As of the time of composing this report, the patient has been diligently monitored for 39 months post-surgery, exhibiting no indications of recurrence, and has demonstrated exceptional tolerance to the entire treatment regimen.

Conclusions: We have first reported a clinically successful case of neoadjuvant combination chemotherapy with pembrolizumab in the treatment of pLCNEC. This case offers promising clinical insights and suggests that this therapeutic approach could be a viable option for managing pLCNEC.

Keywords: Case report; MPR; Neoadjuvant immunochemotherapy; pLCNEC.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Neuroendocrine* / drug therapy
  • Drug Therapy, Combination
  • Humans
  • Lung Neoplasms* / drug therapy
  • Male
  • Middle Aged
  • Neoadjuvant Therapy