OBJECTIVES: Pulmonary pleomorphic carcinoma (PC) is a rare type of lung tumor 
with a dismal prognosis. There is no consensus on a chemotherapy regimen for PC, 
and conventional platinum-based chemotherapy has been associated with 
disappointing response rates and PFS. In searches for a new regimen, the 
sarcomatoid (spindle or giant cell) component has been assumed to be susceptible 
to chemotherapy used for soft tissue sarcoma.
MATERIALS AND METHODS: The medical records of 17 patients who received mesna, 
doxorubicin, ifosfamide, and dacarbazine (MAID) for advanced PC between January 
2010 and February 2017 were retrospectively analyzed for clinicopathological 
features and outcomes.
RESULTS AND CONCLUSION: The median age was 59 years. Sixteen patients were male, 
and only one patient had never smoked. Six patients achieved partial response to 
MAID, leading to an objective response rate of 35%. The median PFS was 2.8 
months, and the median OS was 8.7 months. Hematologic toxicity-related adverse 
events were the most frequent, which comprised grade 3-4 anemia in 35% of 
patients, neutropenia in 47%, thrombocytopenia in 24%, and febrile neutropenia 
in 29%. No febrile neutropenia was reported in patients who received 5-day 
granulocyte-colony stimulating factor (G-CSF) prophylaxis. Most adverse events 
resolved without complications, except for one death due to sepsis. MAID is an 
effective, and possibly important, regimen for PC. MAID could be more safely 
used in clinical practice with appropriate dose modifications and G-CSF primary 
prophylaxis according to patients' status.