PMC9871463_01
Imaging changes. (A) For PET-CT at diagnosis versus PET-CT after comprehensive treatment, the overall efficacy was PR. (B) CT images of Toripalimab during the different treatment periods. (C) The timeline of the main events of this case report.
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No other metastases were detected ( Figure 1A ). In March 2022, PET-CT showed an inactive or substantially suppressed tumor in the right upper lobe near the lung hilum ( Figure 1A ). At the time of writing this report (August 2022), the patient has been followed for 33 months and continues to evidence a durable response with toripalimab treatment ( Figures 1B, C ).
Basic information: (A) Lung tumor tissue stained with hematoxylin and HE, (magnification, x100) (B) Lung tumor tissue stained with hematoxylin and HE, (magnification, x400) (C) PD-L1 immunohistochemical (IHC) pathology, (magnification, x400). (D) Next-generation gene sequencing revealed mutations in theMSH-2. (E) Next-generation gene sequencing revealed mutation in the MSH-6.
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Pathological examination of the tissue from the right upper lung revealed moderately differentiated squamous cell carcinoma ( Figures 2A, B ). PD-L1 expression revealed a tumor proportion score of 1% ( Figure 2C ). Paraffin-embedded tumor tissues with 60% of tumor purity and matched blood were subjected to genomic profiling using an NGS panel of 437 cancer-related genes (3D Medicines Inc, Figure 2D ), MSH6 (p.F1104Lfs*11Exon5) ( Figure 2E ), TP53 (p.R213*Exon6), and PTEN (p.R130QExon5) were found ( Table 1 ). Further, NGS.