CASE REPORT article
Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1527719
This article is part of the Research TopicCommunity Series in Immune Responses Against Tumors - From the Bench to the Bedside: Volume IIView all 8 articles
Curative effect and mechanism of sovantinib combined with toripalimab in the treatment of 1 case of lung large-cell neuroendocrine carcinoma
Provisionally accepted
Shuanglong Xiong*
Chengxiang Yang
Kaiwen FuXingyun Liao
Yao DingKexue Zhou
Li ZhangYan TengChunlan WuYongsheng Li*Yan Li*- Cancer Hospital, Chongqing University, Chongqing, China
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Background: Large-cell neuroendocrine lung carcinoma (LCNEC) is a rare heterogeneous tumour with rates ranging from 2.1% to 3.5%. The overall prognosis of pulmonary LCNEC is poor, and the 5-year overall survival rate is only 21%.Advanced LCNEC treatment drugs are limited, and their efficacy is low. Here, we report a case of advanced lung LCNEC treated with front-line chemotherapy, which significantly delayed tumour progression after combined therapy with targeted immunotherapy. Moreover, we explore the mechanism of the correlation between dynamic changes in the immune microenvironment and therapeutic effects.We describe a patient with advanced pulmonary LCNEC who achieved disease remission and progression-free survival (PFS) of up to 15.1 months after chemotherapy with first-line EP and second-line FOLFIRI. In February 2022, this patient, a 58-year-old male, was diagnosed with left lung large-cell neuroendocrine carcinoma. The initial stage was cT1N2M1aIVA (right lung); however, the disease progressed after 6 cycles of EP chemotherapy, and the revised diagnosis was left lung large-cell neuroendocrine carcinoma, stage cT4N3M1a IVA (right lung).The patient participated in the "randomized, open, multicentre phase III clinical study to evaluate the efficacy and safety of solantinib combined with toripalimab versus FOLFIRI as second-line treatment for advanced neuroendocrine carcinoma", and the efficacy of the FOLFIRI regimen was evaluated after 4 cycles of chemotherapy for PD. The best results were a partial response (PR) and a PFS of up to 15.1 months.This case confirmed the efficacy of ICI therapy against TMB-H lung large-cell neuroendocrine carcinoma, suggesting that the immune microenvironment and TMB analysis are helpful for guiding the personalized treatment of LCNEC.
Keywords: Lung large-cell neuroendocrine carcinoma, Sofantinib, Toripalimab, immune microenvironment, TMB
Received: 13 Nov 2024; Accepted: 04 Aug 2025.
Copyright: © 2025 Xiong, Yang, Fu, Liao, Ding, Zhou, Zhang, Teng, Wu, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shuanglong Xiong, Cancer Hospital, Chongqing University, Chongqing, China
Yongsheng Li, Cancer Hospital, Chongqing University, Chongqing, China
Yan Li, Cancer Hospital, Chongqing University, Chongqing, China
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