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[A Case Report of AFP-producing Primary Lung Squamous Cell Carcinoma with Significant Therapeutic Effect]
Qing Chen1, Yanbo Wang2, Wenjie Zhang1,3
1Department of Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China.
Background:
Primary lung squamous carcinoma that produces alpha-fetoprotein (AFP) is rare and only four related cases have been reported so far. The specific reasons for elevated serum level of AFP and effective treatment regimens for AFP-producing lung squamous carcinoma are not clear. This paper reports the diagnosis and treatment of AFP-producing lung squamous carcinoma so as to provide some references for similar cases in clinical practice.
Methods:
The diagnosis and treatment of an AFP-producing lung squamous carcinoma patient admitted to the Shandong Cancer Hospital on October 23, 2020 was retrospectively analyzed, and literatures were reviewed.
Results:
A 52-year-old male patient was diagnosed as T4N3M0 stage, IIIc right upper lobe lung squamous cell carcinoma with mediastinal lymph node metastasis and multiple metastases in the lung. The main tumor marker was abnormally increased serum AFP. After the rapid progression of two lines chemotherapy, the patient was given anlotinib combined with carrizumab as third-line treatment. The efficacy evaluation reached to partial response (PR) and stable disease (SD) after 2 and 4 cycles of treatment, respectively. The treatment regimen was replaced with albumin paclitaxel plus carrizumab due to gastrointestinal bleeding after the fifth cycle. The patient's condition was under continuous control.
Conclusions:
The AFP-producing lung squamous carcinoma patient had a good response to anlotinib and immunotherapy in the case report, which may provide some guidances for the clinical practice and the research on AFP-producing lung squamous carcinoma.
Insights
Alpha-fetoprotein (AFP) producing lung squamous cell carcinoma is rare. This case report shows a patient with advanced disease responded well to anlotinib and immunotherapy, offering insights for clinical practice.
Area of Science:
- Oncology
- Medical Research
Background:
- Primary lung squamous cell carcinoma producing alpha-fetoprotein (AFP) is exceptionally rare, with limited reported cases.
- The underlying mechanisms for elevated AFP and optimal treatment strategies for this subtype remain unclear.
Observation:
- A 52-year-old male presented with advanced (Stage IIIc) lung squamous cell carcinoma with mediastinal and lung metastases.
- Elevated serum AFP was the primary tumor marker abnormality.
- The patient experienced rapid progression after two lines of chemotherapy.
Findings:
- Third-line treatment with anlotinib plus carrizumab achieved partial response and stable disease.
- Subsequent treatment with albumin paclitaxel plus carrizumab maintained disease control despite gastrointestinal bleeding.
Implications:
- This case suggests that anlotinib and immunotherapy may be effective treatment options for AFP-producing lung squamous cell carcinoma.
- Findings may guide future clinical practice and research for this rare oncological entity.
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