Advanced pulmonary carcinoid managed with chemoimmunotherapy and antiangiogenic agent: A case report and literature review.

Abstract

Pulmonary carcinoid (PC) tumors are rare, well-differentiated neuroendocrine neoplasms of the lung with indolent progression and limited therapeutic consensus in advanced stages. While surgery remains the mainstay for localized disease, optimal management strategies for progressive or unresectable cases remain debated. A case of a 56-year-old man diagnosed with a left upper lobe PC was presented. Initial treatment consisted of platinum-based chemotherapy followed by traditional Chinese medicine. Upon disease progression, he received thoracic radiotherapy, achieving transient stabilization. However, subsequent radiologic surveillance revealed enlargement of mediastinal lymph nodes, prompting the initiation of a triple-modality systemic regimen comprising lobaplatin, the PD-1 inhibitor sintilimab, and the antiangiogenic agent anlotinib. After two treatment cycles, follow-up imaging demonstrated marked lymph node regression with satisfactory tolerability. This case highlights the potential therapeutic value of integrating chemotherapy, immunotherapy and antiangiogenic therapy in advanced PCs, particularly when standard surgical approaches are unfeasible. Although randomized data remain scarce, experience suggests that multimodal systemic therapy may offer disease control in selected patients. Further prospective studies are warranted to refine treatment paradigms for this uncommon malignancy.