Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumab
Pulmonary pleomorphic carcinoma (PPC) is a rare and aggressive lung malignancy with limited treatment options. While immune checkpoint inhibitors (ICIs) have shown promise in treating PPC, evidence regarding their efficacy in epidermal growth factor receptor (EGFR)-mutated cases remains scarce. We r...
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Elsevier
2025-01-01
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| Series: | Respiratory Medicine Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S221300712500070X |
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| author | Yuki Hatakeyama Hidenori Mizugaki Noriyuki Yamada Yasushi Mizukami Ken Kuwahara Hajime Asahina Hirofumi Adachi Hiroshi Yokouchi Yoshihiro Matsuno Satoshi Oizumi |
| author_facet | Yuki Hatakeyama Hidenori Mizugaki Noriyuki Yamada Yasushi Mizukami Ken Kuwahara Hajime Asahina Hirofumi Adachi Hiroshi Yokouchi Yoshihiro Matsuno Satoshi Oizumi |
| author_sort | Yuki Hatakeyama |
| collection | DOAJ |
| description | Pulmonary pleomorphic carcinoma (PPC) is a rare and aggressive lung malignancy with limited treatment options. While immune checkpoint inhibitors (ICIs) have shown promise in treating PPC, evidence regarding their efficacy in epidermal growth factor receptor (EGFR)-mutated cases remains scarce. We report a case of a woman in her 70s diagnosed with PPC harboring EGFR L858R + E709K mutations and high expression (95 %) of programmed death-ligand 1 (PD-L1). After relapsing from concurrent chemoradiotherapy for a Pancoast tumor, the patient received osimertinib as second-line therapy. Despite an initial response, rapid disease progression necessitated left lower lobectomy, confirming PPC diagnosis. Subsequent treatment with pembrolizumab achieved notably tumor response. Although Grade 3 immune-related colitis developed, it was successfully managed with prednisolone, allowing completion of six courses of pembrolizumab. This case demonstrates the potential efficacy of ICIs in EGFR-mutated PPC, even after epidermal growth factor receptor -tyrosine kinase inhibitor (EGFR-TKI) failure and highlights the importance of appropriate adverse event management. Our findings suggest that ICIs may be a viable treatment option for EGFR-mutated PPC patients, particularly those with high PD-L1 expression. |
| format | Article |
| id | doaj-art-f4a5252b32ca454e8c9e54d951692f90 |
| institution | DOAJ |
| issn | 2213-0071 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj-art-f4a5252b32ca454e8c9e54d951692f902025-08-20T03:15:37ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015610223410.1016/j.rmcr.2025.102234Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumabYuki Hatakeyama0Hidenori Mizugaki1Noriyuki Yamada2Yasushi Mizukami3Ken Kuwahara4Hajime Asahina5Hirofumi Adachi6Hiroshi Yokouchi7Yoshihiro Matsuno8Satoshi Oizumi9Department of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, Japan; Corresponding author. Department of Respiratory Medicine, NHO Hokkaido Cancer Center, 2-3-54, 4jou, Kikusui, Shiroishi-Ku, Hokkaido, 003-0804, Sapporo, Japan.Department of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Thoracic Surgery, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Diagnostic Pathology, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Thoracic Surgery, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Diagnostic Pathology, NHO Hokkaido Cancer Center, Sapporo, JapanDepartment of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, JapanPulmonary pleomorphic carcinoma (PPC) is a rare and aggressive lung malignancy with limited treatment options. While immune checkpoint inhibitors (ICIs) have shown promise in treating PPC, evidence regarding their efficacy in epidermal growth factor receptor (EGFR)-mutated cases remains scarce. We report a case of a woman in her 70s diagnosed with PPC harboring EGFR L858R + E709K mutations and high expression (95 %) of programmed death-ligand 1 (PD-L1). After relapsing from concurrent chemoradiotherapy for a Pancoast tumor, the patient received osimertinib as second-line therapy. Despite an initial response, rapid disease progression necessitated left lower lobectomy, confirming PPC diagnosis. Subsequent treatment with pembrolizumab achieved notably tumor response. Although Grade 3 immune-related colitis developed, it was successfully managed with prednisolone, allowing completion of six courses of pembrolizumab. This case demonstrates the potential efficacy of ICIs in EGFR-mutated PPC, even after epidermal growth factor receptor -tyrosine kinase inhibitor (EGFR-TKI) failure and highlights the importance of appropriate adverse event management. Our findings suggest that ICIs may be a viable treatment option for EGFR-mutated PPC patients, particularly those with high PD-L1 expression.http://www.sciencedirect.com/science/article/pii/S221300712500070XPleomorphic carcinomaEGFR mutationPembrolizumabImmunotherapyPD-L1Osimertinib |
| spellingShingle | Yuki Hatakeyama Hidenori Mizugaki Noriyuki Yamada Yasushi Mizukami Ken Kuwahara Hajime Asahina Hirofumi Adachi Hiroshi Yokouchi Yoshihiro Matsuno Satoshi Oizumi Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumab Respiratory Medicine Case Reports Pleomorphic carcinoma EGFR mutation Pembrolizumab Immunotherapy PD-L1 Osimertinib |
| title | Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumab |
| title_full | Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumab |
| title_fullStr | Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumab |
| title_full_unstemmed | Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumab |
| title_short | Response of EGFR-mutated pulmonary pleomorphic carcinoma to pembrolizumab |
| title_sort | response of egfr mutated pulmonary pleomorphic carcinoma to pembrolizumab |
| topic | Pleomorphic carcinoma EGFR mutation Pembrolizumab Immunotherapy PD-L1 Osimertinib |
| url | http://www.sciencedirect.com/science/article/pii/S221300712500070X |
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