PMC5754312_01
Chest computed tomography scans of the patient with lung adenocarcinoma. Before treatment with afatinib, (a) a 34 mm tumor and (b) interlobular septal thickening were observed in the right lower lobe of the lung. After four weeks of afatinib therapy, and before treatment with osimertinib, (c) the lung tumor had enlarged and (d) new small metastatic nodules had appeared. Six months after treatment with osimertinib, (e) the lung tumor had remarkably regressed, and (f) the metastatic nodules and interlobular septal thickening were no longer observed.
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A chest computed tomography scan showed a 34 mm solid nodule in the right lower lobe with multiple small nodules in both lungs, evidence of lymphangitic carcinomatosis in the right lower lobe, and enlargement of the subcarinal and left supraclavicular lymph nodes (Fig 1a,b). However, the lung lesions enlarged, and new lung metastases appeared four weeks after the initiation of therapy (Fig 1c,d). The patient's lung cancer has remained progression-free for seven months (Fig 1e,f).