PMC9168362_01
Radiologic findings during treatment (A) before any treatment (B) Post-treatment image after three cycles of pemetrexed and cisplatin (C) before Afatinib treatment (D) CT of the chest showing PR after 1month of Afatinib (E) before nivolumab treatment (F) CT of the chest showing PD after 4 cycles of Nivolumab.
fphar-13-714408-g001.jpg
PMC9168362_01_fphar-13-714408-g001.jpg
F1
A chest computed tomography (CT) scan indicated a space-occupying lesion in the left lower lobe with miliary distribution of multiple tiny nodules in both lungs, and local bone destruction at the right scapula (Figure 1A). The patient received six cycles of Pemetrexed and Cisplatin which result in partial response (PR) (Figure 1B). Thereafter, progression of lung was demonstrated in CT scan in May 2017 (Figure 1C). Encouragingly, CT imaging showed radiological PR in bilateral lung lesions after 1 month (Figure 1D). However, Afatinib treatment was interrupted after a total of 11 months therapy due to rapid progression of pulmonary lesions and brain metastases (Figure 1E). Compared with the CT images before immunotherapy, it appeared pleural effusion (Figure 1F).
The whole course of treatment of the patient.
fphar-13-714408-g002.jpg
PMC9168362_01_fphar-13-714408-g002.jpg
F2
The entire treatment process of the patient is shown in Figure 2.