P2.01-042 Perioperative Chemotherapy with Pemetrexed and Cisplatin for Pulmonary LCNEC: A Case Report and Literature Review

Abstract

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is associated with poor prognosis, and its treatment strategy is still controversial, especially chemotherapy regimens. Case Report: A 49-year-old Chinese male with primary pulmonary LCNEC treated by neoadjuvant and adjuvant chemotherapy with cisplatin plus pemetrexed was presented in this paper. A suspected quasi-circular mass in the left lower pulmonary lobe and an enlarged mediastinal lymph node were found. The patient was diagnosed with adenocarcinoma with neuroendocrine differentiation based on CT guided percutaneous lung biopsy. EGFR gene mutation test showed negative results. Cisplatin and pemetrexed were administered as the neoadjuvant chemotherapy regimen. The primary lesion had remarkably reduced and the enlarged mediastinal lymph node had disappeared after two cycles of neoadjuvant chemotherapy. He was performed left lower lobectomy and mediastinal lymph node dissection. The lesion was confirmed as LCNEC based on postoperative histopathological analysis and immunohistochemical results. The patient underwent four cycles of adjuvant chemotherapy with cisplatin and pemetrexed for a month postoperatively, followed by postoperative adjuvant radiotherapy. The patient is still alive after a follow-up of 24 months, with no evidence of tumor recurrence. Cisplatin combined with pemetrexed is effective and safe for patients with pulmonary LCNEC.