Synchronous small-cell lung cancer and metastatic gastric gastrointestinal stromal tumor: concurrent chemo-radiotherapy, consolidation immunotherapy, and imatinib

Introduction: We present the case of a 63-year-old male smoker diagnosed synchronously with limited-stage small-cell lung cancer (SCLC) and metastatic gastric gastrointestinal stromal tumor (GIST) with extensive hepatic involvement.Case report: After completing the diagnostic workup, chemotherapy and concurrent radiotherapy were initiated for the SCLC, considered to have the worse prognosis.Subsequent hepatic biopsy confirmed metastatic histology secondary to GIST, leading to concurrent treatment with imatinib.The patient is currently receiving maintenance immunotherapy according to the ADRIATIC regimen.After 9 months of treatment, he shows a complete radiological response of the SCLC and a partial response of the metastatic GIST.Discussion: A literature search identified case reports of patients with GIST and SCLC, but no evidence was found of the concurrent use of imatinib with chemotherapeutic agents and immunotherapy.Conclusions: The favorable outcome suggests that, in selected patients with synchronous tumors and good performance status, a multimodal approach should be pursued to optimize clinical outcomes.With the growing use of immunotherapy, potential interactions between tyrosine kinase inhibitors and immunotherapy deserve further investigation.