Neoadjuvant chemotherapy combined with immunotherapy for pulmonary large-cell neuroendocrine carcinoma: a case report

Lung cancer can be divided into small cell lung cancer and non-small cell lung cancer (NSCLC). NSCLC can be further divided into squamous cell carcinoma, adenocarcinoma, and large-cell neuroendocrine carcinoma (LCNEC). At present, our understanding of LCNEC is limited. LCNEC is a rare condition but is highly malignant with a poor prognosis. The mean age of onset was about 65 years old, and was highly correlated with smoking. Although many treatment methods, including surgery, radiotherapy, and chemotherapy, are available, the therapeutic effect was limited and there is still a lack of clear guidelines and recommendations for its therapy. At present, immunotherapy is rapidly developing, and its application in lung cancer is increasing. However, there is limited literature about immunotherapy in LCNEC. Here, we present a case of LCNEC at stage IIIA, which involved a 64-year-old man with a 30-year history of smoking. Enhanced chest radiography indicated a malignant tumor in the upper lobe of the left lung. We treated this patient with neoadjuvant chemo-immunotherapy with albumin paclitaxel, carboplatin, and sintilimab. We also performed postoperative chemo-immunotherapy the same as before surgery. The patient has well tolerated this treatment and remains under postoperative observation for 6 months at the time of writing.