Penpulimab and Anlotinib in PDL1 high-expression pulmonary giant cell carcinoma with cerebral metastases: case report and review

Pulmonary giant cell carcinoma (PGCC) is a rare subtype of non-small cell lung cancer (NSCLC) characterized by complex pathology, high rates of misdiagnosis or missed diagnosis, an aggressive clinical course, rapid progression, and poor prognosis. This case report describes a 67-year-old Chinese male with a left upper lobe lung mass, diagnosed via CT-guided lung biopsy as PGCC with symptomatic multiple cerebral metastases. The tumor showed strong PD-L1 positivity, and genetic testing revealed a TP53 exon 4 c.313G mutation. Treatment involved first-line therapy with Penpulimab injection combined with Anlotinib and concurrent cranial radiotherapy. Significant reduction in both the pulmonary and cerebral metastatic lesions was observed, with notable efficacy. As of June 2024, there has been no disease progression for 26 months, with the patient currently maintained on Anlotinib monotherapy. This case demonstrates the favorable efficacy of Penpulimab injection combined with Anlotinib in treating advanced PGCC. These findings indicate that this combination therapy may offer a promising new therapeutic option for this rare type of lung cancer.