Table 1_Successful management of synchronous prostate adenocarcinoma and lung squamous cell carcinoma with sintilimab and ADT in a frail elderly patient with bronchiectasis: a case report.docx

Baseline comprehensive geriatric assessment (CGA) confirmed high chemotherapy toxicity risk, and the patient’s family declined platinum-doublet intensive chemotherapy. Initial combined androgen deprivation therapy (ADT) for prostate cancer plus afatinib first-line targeted therapy for LUSC failed to control the disease, followed by progressive disease after second-line single-agent vinorelbine. Subsequently, standard-dose sintilimab (PD-1 inhibitor) monotherapy was administered as third-line treatment for LUSC with continuous ADT maintained for prostate cancer.</p>Results<p>Serial radiology revealed durable marked regression of lung lesions and sustained stable prostate disease, achieving synchronous dual-tumor control.

Sintilimab was prescribed on a q21-day schedule but was not delivered uninterruptedly: 12 administrations were given between December 24, 2024 and June 9, 2026, with infection-related interruptions, including a longest interval of more than 3 months. Recurrent bronchiectasis exacerbations with Pseudomonas aeruginosa infection were managed by culture-directed antibiotics and temporary interruption rather than permanent cessation of immunotherapy.

No grade 2 or higher immune-related adverse events were documented during the reported follow-up, and the patient’s clinical condition and tumor status were stable at the latest recorded follow-up.</p>Conclusion<p>This single case describes the clinical feasibility of standard-dose sintilimab plus ongoing ADT for synchronous prostate adenocarcinoma and LUSC in a frail elderly patient who declined platinum-doublet intensive chemotherapy.

The observed response occurred in the context of intermittent, infection-related treatment delays and should not be interpreted as proof of a causal immune-endocrine mechanism. Because tumor-cell PD-L1 TPS was unavailable, biomarker-based conclusions cannot be drawn. This hypothesis-generating observation may inform future studies and individualized decision-making in similarly complex patients.</p>