INTRODUCTION: Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of 
non-small cell lung carcinoma (NSCLC), which characterized by insensitive to 
conventional radiotherapy and chemotherapy and poor prognosis. Except MET exon 
14 alterations and other oncogene mutations, PSC commonly harbor high tumor 
mutational burden (TMB) and high level of PD-L1, which provide new therapeutic 
opportunities. Toripalimab (JS001) is IgG4 monoclonal antibody targeting PD-1, 
which has been approved for treatment of patients with metastatic melanoma after 
previous systemic therapy. PD-1 combined with radiotherapy has been tried in 
several cancer types.
CASE PRESENTATION: We reported a case of a PSC patient with PD-L1 overexpression 
responding to toripalimab and after progression the patients also benefits from 
toripalimab combined with local radiotherapy, which provides a promising option 
for PSC patients.
CONCLUSION: This case provides the evidence of the effective role of toripalimab 
and PD-1 combined with local radiotherapy in PSC patients, which was the first 
application as far as we know.