Long survival of PD-L1-positive mediastinal sarcomatoid carcinoma after immunotherapy and anti-angiogenic target therapy: A case report.

Mediastinal sarcomatoid carcinoma (SC) is rare and is often associated with poor survival outcomes. At present, there have been no investigations into the use of immunotherapy and anti-angiogenic target therapy to treat mediastinal SC. In the present study, a 74-year-old woman with mediastinal SC who achieved long-term survival was described. Immunohistochemistry of tumor specimens showed high expression of programmed cell death ligand 1 (PD-L1) and a combined positive score of 80. The patient initially received two cycles of chemotherapy and one cycle of radiotherapy combined with anlotinib; subsequent evaluation confirmed stable disease. After which, the patient received two cycles of immunotherapy with durvalumab, and received continued administration with anlotinib; follow-up evaluation revealed a partial response. Immunotherapy was halted due to severe adverse effects, but treatment with anlotinib has remained ongoing. At present, the patient remains alive with no evidence of disease progression, achieving a progression-free survival of >42 months. The present case report highlights the potential of immunotherapy combined with anti-angiogenic targeted therapy in treating PD-L1-positive mediastinal SC, despite the life-threatening adverse reactions, offering a viable treatment option for similar clinical cases.