Literature regarding the treatment of lung cancer
in lung transplant recipients is scant. Treatment option
for this group of patient is often limited given their
immunosuppressive status and comorbidities. In our study,
patients with advanced stage disease generally had poor
survival regardless of chemotherapy. The longest surviving
patient with stage IV upon diagnosis (survival 9.8 months
from diagnosis) had small cell lung cancer and received
chemotherapy with carboplatin/etoposide. The other four
patients with metastatic disease at diagnosis had NSCLC
with survival ranging between 1.3 to 4.7 months.
Patients who later developed metastatic disease, however,
had a mixed response subsequent to chemotherapy. Three
patients with stage I–II who later developed metastasis were
treated with systemic therapy with best response measured
as complete response in one, progression of disease in
another, and not evaluable in the third case. The longest
surviving patient was the one with complete response
(10 months since initiation of chemotherapy) who eventually
succumbed to transplant rejection rather than malignancy.