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Updated: Nov 9, 2025
Using 22C3 Anti-PD-L1 Antibody Concentrate on Biopsy and Cytology Samples from Non-small Cell Lung Cancer Patients
Published on: September 25, 2018
Two different patients with pulmonary pleomorphic carcinoma response to PD-1 inhibitor plus anlotinib
Yuxi Luo1, Jianping Wei2, Jing Zhang3
1Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China; Jiangxi Key Laboratory of Clinical Translational Cancer Research, Nanchang, Jiangxi Province, China.
Abstract:
Pulmonary pleomorphic carcinoma (PPC) is a rare and highly malignant subtype of non-small-cell lung cancer (NSCLC), and chemotherapy and radiotherapy are insensitive. Some clinical trials have shown that targetable driver gene mutations, such as EGFR, ALK or BRAF, have rarely been detected in PPC patients, but the incidence of MET exon 14 mutations is more frequent. For these patients with driver gene mutations, corresponding molecular targeted therapy may be valid. In addition, limited cases have suggested that immunotherapy may be effective for PPC without sensitising EGFR or ALK alterations, but the efficacy in patients with other driver mutations remains unclear. Herein, we reported two PPC patients with different targetable gene mutations who both responded dramatically to the PD-1 inhibitor camrelizumab combined with the oral anti-angiogenic drug anlotinib: one harbouring a BRAF V600E mutation with positive PD-L1 expression, few tumour-infiltrating lymphocytes (TILs) and abundant tumour blood vessels; and the other exhibiting a MET exon 14 skipping mutation with PD-L1 overexpression, scattered TILs and abundant tumour blood vessels. Our findings suggest that PD-1 inhibitor combined with anlotinib may be a potential treatment for PPC patients, and abundant tumour vessels should be investigated as a possible therapeutic biomarker.
Insights
Pulmonary pleomorphic carcinoma (PPC), a rare non-small-cell lung cancer, shows promise with combined PD-1 inhibitor and anlotinib therapy. This combination demonstrated dramatic responses in two patients with distinct driver mutations, suggesting a potential new treatment strategy.
Area of Science:
- Oncology
- Medical Science
Background:
- Pulmonary pleomorphic carcinoma (PPC) is a rare, aggressive non-small-cell lung cancer (NSCLC) subtype.
- Chemotherapy and radiotherapy show limited efficacy in PPC.
- Targetable driver mutations are infrequent, except for MET exon 14 mutations, and immunotherapy's role is unclear in specific mutation contexts.
Purpose of the Study:
- To report the efficacy of a combination therapy in PPC patients with targetable driver mutations.
- To investigate the potential of PD-1 inhibitor plus anlotinib in PPC treatment.
- To explore potential predictive biomarkers for this combination therapy.
Main Methods:
- Case report of two PPC patients with distinct driver mutations (BRAF V600E and MET exon 14 skipping).
- Treatment administered: PD-1 inhibitor (camrelizumab) combined with anlotinib.
- Assessment of clinical response, PD-L1 expression, tumor-infiltrating lymphocytes (TILs), and tumor vasculature.
Main Results:
- Both patients exhibited dramatic responses to the combination therapy.
- Patient 1: BRAF V600E mutation, positive PD-L1, few TILs, abundant tumor vessels.
- Patient 2: MET exon 14 skipping mutation, PD-L1 overexpression, scattered TILs, abundant tumor vessels.
Conclusions:
- PD-1 inhibitor combined with anlotinib may represent a viable treatment option for PPC patients.
- Abundant tumor vasculature could serve as a predictive biomarker for treatment response.
- Further investigation into this combination therapy and biomarker is warranted.
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