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Anti-PD-1 Therapy Achieved Disease Control After Multiline Chemotherapy in Unresectable KRAS-Positive Hepatoid Lung Adenocarcinoma: A Case Report and Literature Review

Authors Chen L, Han X, Gao Y, Zhao Q, Wang Y, Jiang Y, Liu S, Wu X, Miao L

Received 4 February 2020

Accepted for publication 28 April 2020

Published 19 May 2020 Volume 2020:13 Pages 4359—4364


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Sanjay Singh

Lulu Chen,1 Xue Han,2 Yujuan Gao,1 Qi Zhao,1 Yongsheng Wang,1 Ya Jiang,2 Sisi Liu,2 Xue Wu,3 Liyun Miao1

1Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China; 2Department of Research and Development, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, People’s Republic of China; 3Translational Medicine Research Institute, Geneseeq Technology Inc., Toronto, Ontario, Canada

Correspondence: Liyun Miao Email

Abstract: Hepatoid adenocarcinoma of the lung (HAL) is extremely rare and standardized treatment strategy for HAL has not been established. Patients with unresectable HAL have a shorter survival time ranges from 1 to 36 months. Here, we reported a 65-year-old female patient with unresectable alpha-fetoprotein-producing HAL harboring KRAS-G12V and no other targetable driver mutations. The patient was treated with multiple lines of chemotherapies followed by PD-1 inhibitor, sintilimab, due to positive staining of PD-L1, and achieved an overall survival of 52 months. Although the disease was under control, the patient experienced fifth-grade pneumonia and died after 6 months of anti-PD-1 treatment. This is the first case of KRAS-positive HAL patient achieved stable disease by PD-1 inhibitor, which may provide valuable information for the treatment strategy development of advanced HAL patients, and highlights the importance of molecular diagnosis in treatment decision-making.

Keywords: alpha-fetoprotein, anti-PD-1 therapy, hepatoid adenocarcinoma of the lung, KRAS-G12V, sintilimab

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