ORIGINAL PAPER The role of palliative chemotherapy for advanced pulmonary pleomorphic carcinoma Jung Yong Hong Æ Moon Ki Choi Æ Ji Eun Uhm Æ Min Jae Park Æ Jeeyun Lee Æ Yeon Hee Park Æ Jin Seok Ahn Æ Keunchil Park Æ Joung Ho Han Æ Myung Ju Ahn Received: 9 October 2008 / Accepted: 20 October 2008 / Published online: 7 November 2008 Ó Humana Press Inc. 2008 Abstract Pulmonary pleomorphic carcinoma is an uncommon malignant tumor of the lung, which has the dual cell components of spindle or giant cells and epithelial cells. The objective of this study was to investigate the clinical course and efficacy of palliative chemotherapy in patients with advanced pulmonary pleomorphic carcinoma. Twelve patients were diagnosed with advanced pulmonary pleomorphic carcinoma and received palliative chemo- therapy from February 2000 to December 2007. Among the 12 patients, five patients received gemcitabine/ cisplatin, three patients received gemcitabine/carboplatin, two patients received paclitaxel/carboplatin, one patient received paclitaxel/cisplatin, and one patient received docetaxel/cisplatin as first-line chemotherapy. The median patient’s age was 62 (range, 32–72 years). Among the 12 patients, nine patients had relapsed disease after curative resection and three patients had metastatic disease at the initial presentation. After treatment with first-line palliative chemotherapy, seven patients (58%) had progressive dis- ease, three patients (25%) had stable disease, and only two patients (17%) had a partial response. The median overall survival from the day of initiation of first-line chemotherapy was only 8 months (95% CI, 6–10) with median follow-up of 26 months. These results showed the dismal prognosis and the poor response to chemotherapy of advanced pul- monary pleomorphic carcinoma. Further studies are needed to investigate whether the current strategy of palliative chemotherapy for the treatment of advanced pulmonary pleomorphic carcinoma can be justified or not. Moreover, additional novel treatment approaches are required. Keywords Lung cancer Á Pleomorphic carcinoma Á Palliative chemotherapy Introduction Pulmonary pleomorphic carcinoma is a rare malignant tumor of the lung. It is characterized by dual cell compo- nents including spindle or giant cells, and epithelial cells. According to the revised World Health Organization (WHO) classification reported in 2004, pulmonary pleo- morphic carcinoma was defined as poorly differentiated adenocarcinoma, squamous cell carcinoma, or large cell carcinoma containing sarcomatoid components of spindle or giant cells in at least 10% of the cells [1]. Pulmonary pleomorphic carcinoma accounts for only 0.1–0.4% of all pulmonary malignancies [2–4]. Some investigators have reported that pleomorphic carcinoma has a more aggressive clinical course and a poorer survival in comparison to other histological types of non-small cell lung cancer (NSCLC) [3, 5–7]. However, clinical information regarding its malignant grade and clinical behavior is still insufficient due to its rarity. Moreover, information on the efficacy of palliative che- motherapy is extremely limited. Recently, Bae et al. [7] first reported the results of palliative chemotherapy for advanced pulmonary pleomorphic carcinoma, showing a J. Y. Hong Á M. K. Choi Á J. E. Uhm Á M. J. Park Á J. Lee Á Y. H. Park Á J. S. Ahn Á K. Park Á M. J. Ahn (&) Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-gu, 135-710 Seoul, South Korea e-mail: silkahn@skku.edu; silk.ahn@samsung.com J. H. Han Department of Pathology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, South Korea Med Oncol (2009) 26:287–291 DOI 10.1007/s12032-008-9117-4