Primary Pulmonary Lymphoepithelioma-like Carcinoma: A Case Report Utilizing Camrelizumab and Anlotinib for Prolonged Survival
- Authors: Lei S.1, Tian S.2, Lu S.1, Qing Z.1, Long J.1, Li L.1, Yang D.1
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Affiliations:
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital
- Pre-Hospital Emergency Department, Chongqing Emergency Medical Center, Chongqing University Central Hospital
- Issue: Vol 24, No 12 (2024)
- Pages: 954-960
- Section: Oncology
- URL: https://rjsocmed.com/1871-5206/article/view/643791
- DOI: https://doi.org/10.2174/0118715206294031240404071838
- ID: 643791
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Full Text
Abstract
Background:Primary Pulmonary Lymphoepithelioma-like Carcinoma (PPLELC) is a rare form of cancer for which no standard treatment has been established to date. Patients with advanced-stage PPLELC generally have a poor prognosis with overall survival of 22.7 months.
Case Presentation:Here, we report a case of advanced primary pulmonary lymphoepithelioma-like carcinoma. Initially, the patient underwent a first-line (GP) and a second-line (DP) of chemotherapy, which provided temporary relief but resulted in varying degrees of myelosuppression. When the disease progressed again, we administered a third-line treatment consisting of camrelizumab combined with anlotinib.
Result:This resulted in a progression-free survival of over 26 months without significant toxic side effects.
Conclusion:Our findings suggest that combining camrelizumab and anlotinib could lead to a long progressionfree survival in patients with advanced PPLELC.
About the authors
ShuangYi Lei
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital
Author for correspondence.
Email: info@benthamscience.net
ShanShan Tian
Pre-Hospital Emergency Department, Chongqing Emergency Medical Center, Chongqing University Central Hospital
Email: info@benthamscience.net
SongMei Lu
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital
Email: info@benthamscience.net
Zhou Qing
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital
Email: info@benthamscience.net
JianLin Long
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital
Email: info@benthamscience.net
LuChun Li
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital
Email: info@benthamscience.net
Dan Yang
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Medical Oncology, Chongqing University Cancer Hospital
Author for correspondence.
Email: info@benthamscience.net
References
- Bégin, L.R.; Eskandari, J.; Joncas, J.; Panasci, L. Epstein‐barr virus related lymphoepithelioma‐like carcinoma of lung. J. Surg. Oncol., 1987, 36(4), 280-283. doi: 10.1002/jso.2930360413 PMID: 2826922
- Han, A.; Xiong, M.; Zong, Y. Association of Epstein-Barr virus with lymphoepithelioma-like carcinoma of the lung in southern China. Am. J. Clin. Pathol., 2000, 114(2), 220-226. doi: 10.1309/148K-ND54-6NJX-NA61 PMID: 10941337
- Chang, Y.L.; Wu, C.T.; Shih, J.Y.; Lee, Y.C. New aspects in clinicopathologic and oncogene studies of 23 pulmonary lymphoepithelioma-like carcinomas. Am. J. Surg. Pathol., 2002, 26(6), 715-723. doi: 10.1097/00000478-200206000-00004 PMID: 12023575
- Castro, C.Y.; Ostrowski, M.L.; Barrios, R.; Green, L.K.; Popper, H.H.; Powell, S.; Cagle, P.T.; Ro, J.Y. Relationship between epstein-barr virus and lymphoepithelioma-like carcinoma of the lung: A clinicopathologic study of 6 cases and review of the literature. Hum. Pathol., 2001, 32(8), 863-872. doi: 10.1053/hupa.2001.26457 PMID: 11521232
- Zhou, Y. Thorough survey and analysis of pulmonary lymphoepithelioma-like carcinoma in Macau and multimodality treatment for advanced disease. Lung Cancer, 2019, 138, 116-123.
- Archwamety, A.; Ruangchira-urai, R.; Akewanlop, C.; Korphaisarn, K. Primary pulmonary lymphoepithelioma‐like carcinoma treated with immunotherapy: A case report and literature review. Thorac. Cancer, 2022, 13(17), 2539-2541. doi: 10.1111/1759-7714.14580 PMID: 35830974
- Fang, W.; Hong, S.; Chen, N.; He, X.; Zhan, J.; Qin, T.; Zhou, T.; Hu, Z.; Ma, Y.; Zhao, Y.; Tian, Y.; Yang, Y.; Xue, C.; Tang, Y.; Huang, Y.; Zhao, H.; Zhang, L. PD-L1 is remarkably over-expressed in EBV-associated pulmonary lymphoepithelioma-like carcinoma and related to poor disease-free survival. Oncotarget, 2015, 6(32), 33019-33032. doi: 10.18632/oncotarget.5028 PMID: 26361045
- Yi, M.; Jiao, D.; Qin, S. Synergistic effect of immune checkpoint blockade and anti-angiogenesis in cancer treatment. Mol. Cancer, 2019, 18(1), 60. doi: 10.1186/s12943-019-0974-6
- Chang, Y.L.; Wu, C.T.; Shih, J.Y.; Lee, Y.C. Unique p53 and epidermal growth factor receptor gene mutation status in 46 pulmonary lymphoepithelioma‐like carcinomas. Cancer Sci., 2011, 102(1), 282-287. doi: 10.1111/j.1349-7006.2010.01768.x PMID: 21070477
- Curcio, L.D.; Cohen, J.S.; Paz, I.B.; Grannis, F.W., Jr; Chilcote, R.; Weiss, L.M. Primary lymphoepithelioma-like carcinoma of the lung in a child. Report of an Epstein-Barr virus-related neoplasm. Chest, 1997, 111(1), 250-251. doi: 10.1378/chest.111.1.250 PMID: 8996028
- Hoxworth, J.M.; Hanks, D.K.; Araoz, P.A.; Elicker, B.M.; Reddy, G.P.; Webb, W.R.; Leung, J.W.T.; Gotway, M.B. Lymphoepithelioma-like carcinoma of the lung: Radiologic features of an uncommon primary pulmonary neoplasm. AJR Am. J. Roentgenol., 2006, 186(5), 1294-1299. doi: 10.2214/AJR.05.0244 PMID: 16632721
- Chan, J.K.C.; Hui, P.K.; Tsang, W.Y.W.; Law, C.K.; Ma, C.C.; Yip, T.T.C.; Poon, Y.F. Primary lymphoepithelioma-like carcinoma of the lung. A clinicopathologic study of 11 cases. Cancer, 1995, 76(3), 413-422. doi: 10.1002/1097-0142(19950801)76:33.0.CO;2-X PMID: 8625122
- Yoshino, N.; Kubokura, H.; Yamauchi, S.; Ohaki, Y.; Koizumi, K.; Shimizu, K. Lymphoepithelioma-like carcinoma of the lung. Jpn. J. Thorac. Cardiovasc. Surg., 2005, 53(12), 653-656. doi: 10.1007/BF02665079 PMID: 16408473
- Xie, M.; Wu, X.; Wang, F. Clinical significance of plasma epstein-barr virus DNA in pulmonary Lymphoepithelioma-like Carcinoma (LELC). Patients. J. Thorac. Oncol., 2018, 13(2), 218-227. doi: 10.1016/j.jtho.2017.10.031
- Han, A.; Xiong, M.; Gu, Y.; Lin, S.; Xiong, M. Lymphoepithelioma-like carcinoma of the lung with a better prognosis. A clinicopathologic study of 32 cases. Am. J. Clin. Pathol., 2001, 115(6), 841-850. doi: 10.1309/BUAN-BGFW-69U9-C3H8 PMID: 11392880
- Xie, Z.; Liu, L.; Lin, X. A multicenter analysis of genomic profiles and PD-L1 expression of primary lymphoepithelioma-like carcinoma of the lung. Modern Pathol., 2020, 33, 626-638. doi: 10.1038/s41379-019-0391-9
- Kim, C.; Rajan, A.; Debrito, P.A.; Giaccone, G. Metastatic lymphoepithelioma-like carcinoma of the lung treated with nivolumab: A case report and focused review of literature. Transl. Lung Cancer Res., 2016, 5(6), 720-726. doi: 10.21037/tlcr.2016.11.06 PMID: 28149767
- Narayanan, A.; Knollmann, F.D.; Walby, J. EBV positive primary pulmonary Lymphoepithelioma-Like Carcinoma (LELC) Response to PD-L1 Blockade. Clin. Lung Cancer, 2018, 20, 20. PMID: 30679078
- Qiu, Z.X.; Zhou, P.; Wang, K. Primary pulmonary lymphoepithelioma-like carcinoma response favorably to nivolumab: A case report. OncoTargets Ther., 2019, 12, 8595-8600. doi: 10.2147/OTT.S219512 PMID: 31802895
- Xiao, Y.; He, J.; Luo, S. Comparison of immunotherapy, chemotherapy, and chemoimmunotherapy in advanced pulmonary lymphoepithelioma-like carcinoma: A retrospective study. Front. Oncol., 2022, 12, 820302. doi: 10.3389/fonc.2022.820302
- Tang, Z.; Fang, R.; Tong, G. Overcoming resistance to anti-PD-1 immunotherapy in lymphoepithelioma-like carcinoma: A case report and review of the literature. Lung Cancer, 2020, 146, 335-340. doi: 10.1016/j.lungcan.2020.06.027
- Dolesche, D. Regorafenib enhances anti-PD1 immunotherapy efficacy in murine colorectal cancers and their combination prevents tumor regrowth. J. Exp. Clin. Cancer Res., 2021, 40, 288.
- Manegold, C. The potential of combined immunotherapy and antiangiogenesis for the synergistic treatment of advanced NSCLC. J. Thorac. Oncol., 2017, 12, 194-207.
- Han, B.; Li, K.; Wang, Q.; Zhang, L.; Shi, J.; Wang, Z.; Cheng, Y.; He, J.; Shi, Y.; Zhao, Y.; Yu, H.; Zhao, Y.; Chen, W.; Luo, Y.; Wu, L.; Wang, X.; Pirker, R.; Nan, K.; Jin, F.; Dong, J.; Li, B.; Sun, Y. Effect of anlotinib as a third-line or further treatment on overall survival of patients with advanced nonsmall cell lung cancer. JAMA Oncol., 2018, 4(11), 1569-1575. doi: 10.1001/jamaoncol.2018.3039 PMID: 30098152
- Chu, T.; Zhong, R. Zhong, H Phase 1b study of sintilimab plus anlotinib as first-line therapy in patients with advanced NSCLC. J. Thorac. Oncol., 2021, 16(4), 643-652. doi: 10.1016/j.jtho.2020.11.026
- Wang, P.; Fang, X.; Yin, T. Efficacy and safety of Anti-PD-1 plus anlotinib in patients with advanced non-small-cell lung cancer after previous systemic treatment failure-a retrospective study. Front. Oncol., 2021, 11, 628124. doi: 10.3389/fonc.2021.628124
- Liu, S.; Qin, T.; Liu, Z. Anlotinib alters tumor immune microenvironment by downregulating PD-L1 expression on vascular endothelial cells. Cell Death Dis., 2020, 11(5), 309. doi: 10.1038/s41419-020-2511-3
- Liu, Y.; Long, L.; Liu, J. Case report: Anlotinib reverses nivolumab resistance in advanced primary pulmonary lymphoepithelioma-like carcinoma with FGFR3 gene amplification. Front. Oncol., 2021, 11, 749682. doi: 10.3389/fonc.2021.749682
- Ramjiawan, R.R.; Griffioen, A.W.; Duda, D.G. Anti-angiogenesis for cancer revisited: Is there a role for combinations with immunotherapy? Angiogenesis, 2017, 20(2), 185-204. doi: 10.1007/s10456-017-9552-y
- Lee, W.S.; Yang, H.; Chon, H.J. Combination of anti-angiogenic therapy and immune checkpoint blockade normalizes vascular-immune crosstalk to potentiate cancer immunity. Exp. Mol. Med., 2020, 52(9), 1475-1485. doi: 10.1038/s12276-020-00500-y
- Ren, S.; He, J.; Fang, Y. Camrelizumab plus Apatinib in treatment-naive patients with advanced nonsquamous NSCLC: A multicenter, open-label, single-arm, phase 2 trial. JTO Clin. Res. Rep., 2022, 3(5), 100312. doi: 10.1016/j.jtocrr.2022.100312
- Kudo, M.; Finn, R.S.; Cheng, A.L. Albumin-Bilirubin grade analyses of Atezolizumab plus Bevacizumab versus Sorafenib in Patients with Unresectable Hepatocellular Carcinoma: A Post Hoc analysis of the Phase III IMbrave150 study. Liver Cancer, 2023, 12(5), 479-493. doi: 10.1159/000529996
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