Conversion Surgery for Advanced Thoracic SMARCA4-Deficient Undifferentiated Tumor With Atezolizumab in Combination With Bevacizumab, Paclitaxel, and Carboplatin Treatment: A Case Report

Conversion Surgery for Advanced Thoracic SMARCA4-Deficient Undifferentiated Tumor With Atezolizumab in Combination With Bevacizumab, Paclitaxel, and Carboplatin Treatment: A Case Report

A SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rapidly progressing subtype of lung cancer with a poor prognosis and causes early postoperative recurrence among operable patients. In this study, we present a case of SMARCA4-UT with vertebral and chest wall invasion that successfully und...

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Main Authors: Kei Kunimasa, MD, PhD, Jiro Okami, MD, PhD, Satoshi Takenaka, MD, PhD, Keiichiro Honma, MD, PhD, Yoji Kukita, PhD, Shigenori Nagata, MD, PhD, Takahisa Kawamura, MD, PhD, Takako Inoue, MD, Motohiro Tamiya, MD, Hanako Kuhara, MD, PhD, Kazumi Nishino, MD, PhD, Hideaki Tahara, MD, PhD, Toru Kumagai, MD, PhD
Format: article
Language:EN
Published: Elsevier 2021
Subjects:
SMARCA4-deficient undifferentiated tumor
Conversion surgery
Neoadjuvant therapy
Immunotherapy
Case report
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Online Access:https://doaj.org/article/6fce6fc2448440c289bbd4912081d54c
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Summary:A SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rapidly progressing subtype of lung cancer with a poor prognosis and causes early postoperative recurrence among operable patients. In this study, we present a case of SMARCA4-UT with vertebral and chest wall invasion that successfully underwent conversion surgery after treatment with atezolizumab in combination with bevacizumab, paclitaxel, and carboplatin. The surgical specimen comprised SMARCA4-deficient and SMARCA2-positive adenocarcinoma, confirming intratumor heterogeneity. Gene panel analysis revealed no substantial differences in mutant gene profiles among tumors and no differences in SMARCA2 mutations. Furthermore, no recurrence occurred for 9 months after surgery. Thus, this case illustrates the possibility of multidisciplinary treatment including neoadjuvant therapy with immunotherapy and conversion surgery for SMARCA4-UT.

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