P40.02 Pemetrexed in Advanced-stage Lymphoepithelioma Carcinoma of Lung

Abstract

Lymphoepithelioma Carcinoma of Lung （former pulmonary lymphoepithelioma-like carcinoma) is a rare primary lung cancer, which was a subtype of large-cell lung cancer and other and unclassified carcinomas in third and 4th edition WHO classification of tumors, respectively. In the new 5th WHO classification, lymphoepithelioma carcinoma of lung is classified as a subtype of squamous cell carcinoma. As we all known, Pemetrexed isn’t recommended for squamous cell carcinoma. However, little is known about the role of pemetrexed in treatment of advanced-stage lymphoepithelioma carcinoma of lung. From January 2008 to December 2020, we retrospectively analyzed patients who were diagnosed as stage ⅢC-Ⅳ lymphoepithelioma carcinoma of lung and received pemetrexed alone or combination with cisplatin/ carboplatin or checkpoint inhibitor in Guangdong Lung Cancer Institute. A total of 23 patients were included in this study. The majority of patients were female (14/23,60.9%). The median age was 49 years (range 13 to 76 years old). All of patients were EGFR wild type. Among the 10 patients who received first-line pemetrexed alone (2) or combination with cisplatin/ carboplatin (3) or checkpoint inhibitor (5), the response and stable disease (SD) was observed in 2(20%) patients and 7(70%) patients, respectively. In second-line or more treatment, pemetrexed alone achieved stable disease and progress disease in 5 patients (42.7%), 7 patients (57.3%), respectively, except for one patient didn’t received CT scan for assessing response. After median 19.3 months follow-up, PFS and MST in first line and second line or more line were6.8, 36.6, and 2.8, 18.9 months, respectively. Although lymphoepithelioma carcinoma of lung is classified as subtype of squamous cell carcinoma in 5th WHO classification of lung tumors, pemetrexed showed moderate response in advanced stage disease and warrant further study.