2018 Volume 58 Issue 7 Pages 969-974
Background. Pulmonary pleomorphic carcinoma (PPC) is a rare and highly malignant tumor that is considered to be resistant to chemotherapy. We report the cases of two patients with PPC who were treated with pembrolizumab. Case 1. A 64-year-old man was referred to our department with right back pain. A large mass in the right lower lobe was noted and CT-guided percutaneous biopsy of the mass revealed PPC with the high expression of PD-L1 (tumor proportion score 100%), which was classified as clinical stage IVA. He was treated with pembrolizumab as an initial treatment, which led to a partial response. Case 2. A 62-year-old woman was diagnosed with pathological stage IIB (pT3N0M0) PPC after right upper resection following a diagnosis of early clinical stage non-small cell lung carcinoma. Pleural metastasis was noted two months after surgery. The expression of PD-L1 in the resected specimen was low (tumor proportion score 30%). The tumor was responsive to the first-line combined chemotherapy with carboplatin and nab-paclitaxel, but non-responsive to the second-line treatment with pembrolizumab. Conclusion. Pembrolizumab might show a degree of efficacy for PPC with the high expression of PD-L1.
