[A Retrospective Study of 42 Lung Cancer Patients with Pancreatic Metastases]

Camrelizumab combined with chemotherapy for stage IV pulmonary sarcomatoid cancer with pancreatic metastases

The pancreas is a rare metastatic site for lung cancer. We report the case of a 66-year-old male with pulmonary sarcomatoid carcinoma (PSC) with pancreatic and right posterior renal fascia metastases treated with immunotherapy and platinum-based chemotherapy. A pathological biopsy of the right posterior fascial mass showed lung invasive adenocarcinoma and sarcomatoid carcinoma metastasis. Immunohistochemistry staining showed that PD- L1 expression was high and next-generation sequencing revealed KRAS and TP53 mutations. Camrelizumab and chemotherapy were administered, and the metastasis disappeared. Immunotherapy combined with platinum-based chemotherapy is effective in treating PSC with pancreatic metastases.

Case report: Acute pancreatitis in lung adenocarcinoma with small cell transformation after multiple line targeted therapy

In lung cancer, metastasis to the liver, bones, brain, and adrenal glands is more commonly observed, whereas pancreatic metastasis from lung cancer is relatively rare. We present a case of a patient with an 8-year history of lung adenocarcinoma (LUAD) who was admitted to our institution exhibiting symptoms consistent with acute pancreatitis. Subsequent histopathological examination through puncture confirmed the occurrence of pancreatic metastasis originating from small cell lung cancer (SCLC). During a multidisciplinary team discussion, we reached a consensus in diagnosing the patient with post-transformation small cell carcinoma alongside moderately severe pancreatitis, which was determined to be a consequence of pancreatic metastasis. The patient received a regimen of etoposide and cisplatin chemotherapy. This unique clinical case highlights the importance of further investigating the factors contributing to pancreatic metastasis in patients with lung cancer, as the underlying mechanisms remain unclear. Understanding these exceptional metastatic events is vital in devising effective therapeutic strategies and improving patient prognosis. Our findings emphasize the need for continued surveillance and comprehensive management of lung cancer patients, particularly those with resistant forms of the disease, to promptly identify and address the progression of metastatic events to uncommon sites such as the pancreas.

Abscopal effect induced by modulated radiation therapy and pembrolizumab in a patient with pancreatic metastatic lung squamous cell carcinoma

The main recurrence pattern for lung cancer patients after radical surgery is distant metastasis. The probability of pancreatic metastasis in patients diagnosed with lung squamous cell carcinoma is 0.02%, with a poor prognosis. Chemotherapy is the preferred treatment for recurrence. Single lesions or oligometastasis can be surgically resected, and local lesions with compression symptoms can be treated with radiotherapy. The FDA and NMPA have approved first‐line indications for immunotherapy for lung squamous cell carcinoma. Here, we report the case of a 57‐year‐old male patient with lung squamous cell carcinoma who developed pancreatic metastasis after radical resection. The disease progressed after first‐line chemotherapy, and the patient was treated with immunotherapy combined with radiotherapy. We subsequently observed the abscopal effect of intensity modulated radiation therapy (IMRT) and pembrolizumab with disappearance of lung metastasis after radiotherapy for pancreatic metastasis. The patient’s tumor symptoms were relieved with prolonged survival.