PMC9410564_01
Imaging during chemotherapy. Ai-iii First diagnosis. Bi-iii After radiotherapy and chemotherapy. (Ci, ii) Progress after the second chemotherapy.
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Magnetic resonance imaging (MRI) of her brain and spinal cord revealed multiple brain and spinal metastases ( Figures 1Ai,ii ). The response was categorized as PR ( Figures 1Bi,ii ). But the response was categorized as progressive disease (PD) ( Figures 1Ci,ii ).
Bronchoscopic pathology showed small cell lung cancer.
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Bronchoscopic biopsy pathology examination showed evidence of small cell carcinoma ( Figure 2 ).
Imaging during Anlotinib treatment. (A) In December 2019, after anlotinib treatment, cavities formed. (B) In May 2020, void consolidation. (C) In November 2020, after the dose was increased, the lesions shrank again. (D) In October 2021, anlotinib combined with durvalumab shrink the lesion.
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The patient then started taking anlotinib (12 mg d1-d14/q3w) from December 2018 until the scale of the pulmonary lesion shrank and cavitated ( Figure 3A ). The consolidation of lung lesions was reviewed on 14 May 2020 ( Figure 3B ), and the dose of anlotinib was increased to 12 mg considering the risk of disease progression. During this period, the best efficacy was PR ( Figure 3C ), and no adverse reactions were reported. The current clinical effectiveness was PR ( Figure 3D ).
Treatment course and ctDNA NGS test results. (A) The complete treatment path of the patient. (B) Changes in gene mutation frequency and bTMB (C) between 2018 and 2022.
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