Background Thoracic SMARCA4‐deficient undifferentiated tumor (SMARCA4‐UT) of the chest is a highly aggressive smoking‐related thoracic malignancy with a median overall survival (OS) of only 4–7 months. Case Presentation In this article, we report a case of a 74‐year‐old male patient who was admitted to the hospital with recurrent cough with sputum and CT suggestive of a right pleural occupying lesion. Admission to the hospital and perfect CT showed right pleural thickening with multiple metastases in the mediastinum and liver, and the diagnosis of SMARCA4‐UT (SMARCA4 expression deletion) was confirmed by pathologic biopsy and immunohistochemistry. The genetic test map suggested high PD‐L1 expression (TPS 80%) and the patient was treated with sindilizumab (200 mg q3w) combined with bevacizumab (500 mg q3w). Grade 3 immune myocarditis occurred during treatment, and bevacizumab maintenance therapy was continued after discontinuing immunosuppression. During follow‐up, the patient achieved a final OS of 18 months. Conclusions This case suggests that PD‐1 inhibitors combined with antiangiogenic therapy may improve the prognosis of SMARCA4‐UT, but the adverse effects observed during the treatment course demanded equally critical attention.
Wen et al. (Thu,) studied this question.