2022 World Conference on Lung Cancer (ePosters)-EP05.03-011. Bilateral Orthotopic Lung Transplantation for a Patient with Advanced Invasive Mucinous Adenocarcinoma

EP05.03-011. Bilateral Orthotopic Lung Transplantation for a Patient with Advanced Invasive Mucinous Adenocarcinoma

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Researchers from Northwestern University Feinberg School of Medicine in Chicago, USA, successfully performed bilateral orthotopic lung transplantation (BOLT) on a patient with advanced invasive mucinous adenocarcinoma (IMA). IMA is a rare type of lung cancer that often has a poor prognosis due to the lack of effective systemic treatments and actionable genomic alterations. However, in this case, the patient did not have systemic metastasis, and the researchers hypothesized that removing the tumor through lung transplantation could be a life-saving treatment.<br /><br />The 53-year-old male patient had bilateral diffuse IMA with no actionable mutations and a tumor mutation burden of 1.6. Despite multiple standard treatments and a clinical trial, the cancer continued to progress. The patient was then started on lenvatinib in combination with ipilimumab and nivolumab, which led to clinical improvement. However, the patient's condition eventually deteriorated, and they developed respiratory failure, a bronchopleural fistula, and pneumonia with sepsis.<br /><br />After a 17-day waitlist time, the patient underwent BOLT using cardiopulmonary bypass without any complications. Complete cancer extirpation and mediastinal lymph node dissection were successfully accomplished. Six months after the transplantation, the patient was breathing on room air, with normal lung function, and reported independence in daily activities. Minimal residual disease was absent at 1 and 3 months, as detected using a circulating tumor DNA assay. Repeat chest imaging and lung biopsies after six months showed no signs of recurrent disease.<br /><br />This case suggests that BOLT may be a potential life-saving treatment option for carefully selected patients with IMA who do not have systemic metastasis. Further research is needed to investigate the benefits of BOLT in this patient population in prospective studies.

Asset Subtitle

Young Kwang Chae

Meta Tag

Speaker Young Kwang Chae

Topic Locally Advanced Non-small Cell Lung Cancer - Surgery

Keywords

orthotopic lung transplantation

invasive mucinous adenocarcinoma

IMA

lung cancer

systemic treatments

lenvatinib

ipilimumab

nivolumab

respiratory failure

prospective studies