PMC7721275_01
Computed tomography at the first presentation showing a 5-cm massive pulmonary tumor in the left upper lobe and multiple nodules in both lung fields. (A) Mediastinal window, (B) pulmonary window.
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Enhanced computed tomography (CT) showed that the pulmonary mass was a single 5.1 * 5.8cm, invading the first and second left ribs of the upper left lobe (Figure 1).
(A) Histological examination of lung biopsy specimens obtained from the left pulmonary mass revealing proliferation of polyhedral and spindle atypical cells. (B) PD-L1 tumor proportion score was detected by Burning Rock Dx.
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Histological examination of CT-guided percutaneous lung biopsy specimens from the left lung mass showed lung polymorphic carcinoma (Figure 2A). PD-L1 tumor proportion score (TPS) >90% (Dako 22C3 IHC platform) detected by Burning Rock Dx (Figure 2B, Supplementary Materials).
Chest CT images obtained after one course of chemotherapy.
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CT images revealed the enlargement of the tumor with 6.3*7.2cm in diameter (Figure 3). Considering adverse events and adverse effects, we recommend the use of PD-1 inhibitors, such as nivolumab or pembrolizumab.
Chest CT images obtained after 2 weeks (A), 6 weeks (B), and 10 weeks (C) in a patient who received single camrelizumab (PD1 monoclonal antibody) treatment.
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After another 2 treatment cycles, cancerous changes were seen on CT (Figure 4A and B). After five cycles of CT, a partial response was confirmed (solid tumor response evaluation criteria, version 1.1) (Figure 4C).
Reactive cutaneous capillary endothelial cell proliferation (RCCEP) was located on the scalp and trunk of patients before (A) and after (B) apatinib treatment.
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During the course of treatment, except for reactive skin capillary endothelial cell proliferation (RCCEP), no serious adverse events were observed (Figure 5A). Since RCCEP is most located on the scalp and trunk was given, a small molecule intravascular angiogenesis factor 2 receptor 2 (VEGFR-2) tyrosine kinase inhibitor, and RCCEP was significantly reduced (Figure 5A and B).
The expression of EGFR2 was detected by IHC before (A) and after (B) apatinib treatment. (100x).
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At the same time, the expression of VEGFR2 in tumor tissues was significantly decreased (Figure 6).