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Case Reports
. 2022 Mar 7:12:799549.
doi: 10.3389/fonc.2022.799549. eCollection 2022.

Hyperprogressive Disease After Immunotherapy: A Case Report of Pulmonary Enteric Adenocarcinoma

Chun-Hong Hu  1 , Shenghao Shi  1 , Wen Dong  2 , Lizhi Xiao  3 , Hongjing Zang  4 , Fang Wu  1
Affiliations
Case Reports

Hyperprogressive Disease After Immunotherapy: A Case Report of Pulmonary Enteric Adenocarcinoma

Chun-Hong Hu et al. Front Oncol. .

Abstract

Primary pulmonary enteric adenocarcinoma (PEAC) is a rare invasive adenocarcinoma clinically similar to metastatic colorectal adenocarcinoma (MCRC). Although many studies have addressed the differential diagnosis of PEAC, few have described the treatment of PEAC, especially using immunotherapy. This report describes a 61-year-old man who presented initially with pain in the ribs. Pathological analysis of biopsy samples shows malignant tumors of the right pleura, and next-generation sequencing of 26 genes showed a KRAS gene mutation. Positron emission tomography-computed tomography (PET-CT) found no evidence of gastrointestinal malignancy. Due to multiple metastases, the patient could not undergo radical surgery. The patient was treated with a combination chemotherapy regimen of paclitaxel plus carboplatin, along with sindilizumab immunotherapy, but, after one cycle of treatment, the tumor showed a hyperprogressive state. The patient is still being monitored regularly. These findings indicate that chemotherapy combined with immunotherapy may be ineffective in the treatment of primary PEAC with positive driver genes.

Keywords: case report; chemotherapy; hyperprogressive disease; immunity therapy; pulmonary enteric adenocarcinoma.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
IHC: CDX-2 (+).
Figure 2
Figure 2
Pathology imagine.
Figure 3
Figure 3
CT before immunotherapy.
Figure 4
Figure 4
CT after immunotherapy.
See this image and copyright information in PMC

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