PMC9878280_01
Changes in lung tumor and metastatic tumor during camrelizumab and anlotinib treatment. (A) CT showed that the lung tumor began to shrink after first cycle of treatment until the end of treatment. (B) CT showed that the volume of bilateral adrenal invasion lesions was significantly reduced after first cycle of treatment and disappeared after that. (C) CT showed that the volume of the right neck invasion lymph node lesion was significantly reduced to normal after three cycles until the end of treatment.
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Computed tomography (CT) (Figure 1A) revealed a mass in the left lung with bilateral adrenal invasion (Figure 1B) and right neck lymph node invasion (Figure 1C). AFP (8.95 ng/ml; normal value < 7.00), CEA (15.03 ng/ml; normal value < 3.40), CA125 (175.10 U/ml; normal value < 35.00), CA199 (79.27 U/ml; normal value < 27.00), and CA724 (6.03 U/ml; normal value < 6.90) levels were abnormal (Supplementary Figure S1). After one cycle of combination therapy, AFP, CEA, CA125, CA199, and CA724 serum levels decreased to 6.22, 10.17 ng/ml, 148.20, 42.84 U/ml, and 1.26 ng/ml, respectively (Supplementary Figure S1). Three-phase multidetector CT highlighted a marked dimensional reduction of infiltrating focality in the left lung (from 168.48 mm3 to 85.14 mm3) (Figure 1A) and adrenal glands (Figure 1B). CT demonstrated a good response with the reduction of mass in the lung (Figure 1A), adrenal (Figure 1B), and right neck lymph node invasion (Figure 1C). The tumour marker values remained within the normal range (Supplementary Figure S1). Blood cell counts (Supplementary Table S2; Figure 3A), liver function (Supplementary Table S3; Figure 3B), thyroid function (Supplementary Table S4; Figure 3C), and pancreatic function (Supplementary Figure S1) were nearly within normal limits.
HE and IHC of NSCLC tissues, and the three-dimensional reconstruction of tumor. (A) HE showed that the tissues were moderately and poorly differentiated adenocarcinoma (From left to right: x100 magnification, x200 magnification, and x400 magnification). (B) IHC showed that the expression of PD-L1 and PD-1 were positive (Left: x100 magnification, right: x200 magnification). (C) Three-dimensional reconstruction showed that the tumor shrinked after the third cycle.
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T4N3M1 stage IV) (Figure 2A) with mutations in KRAS and TP53 (Table 1). The former mutation was a missense mutation in exon two of the gene, which is predicted to have led to the functional activation of its encoded protein, whereas the TP53 mutation was a splicing mutation in the intron of this gene, which was predicted to have caused the inactivation of protein function. Results of the immunohistochemical analysis showed that the PD-L1 expression score (SP263) in tumour cells was 0.8% and PD-1 staining (Servicebio: GB12338) of CD8 cells in tumor lesions was positive (Figure 2B). Co., Ltd.) to precisely measure the volume of the lesion and found that the tumour size significantly decreased after treatment (Figure 2C). To evaluate safety, changes in blood cell counts (Supplementary Table S2; Figure 3A), liver function (Supplementary Table S3; Figure 3B), and thyroid function (Supplementary Table S4; Figure 3C) were detected and are shown. Changes in pancreatic function are shown in Figure 2. Three-dimensional reconstruction revealed a marked reduction in infiltrating focality in the left lung (Figure 2C).
Changes in blood cell counts, liver function, and thyroid function. (A) Blood cell counts was almost within normal limits until the end of treatment. (B) Liver function was almost within normal limits until the end of treatment. (C) Thyroid function was almost within normal limits until the end of treatment.
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Co., Ltd.) to precisely measure the volume of the lesion and found that the tumour size significantly decreased after treatment (Figure 2C). To evaluate safety, changes in blood cell counts (Supplementary Table S2; Figure 3A), liver function (Supplementary Table S3; Figure 3B), and thyroid function (Supplementary Table S4; Figure 3C) were detected and are shown. Changes in pancreatic function are shown in Figure 2. Blood cell counts (Supplementary Table S2; Figure 3A), liver function (Supplementary Table S3; Figure 3B), thyroid function (Supplementary Table S4; Figure 3C), and pancreatic function (Supplementary Figure S1) were nearly within normal limits. Table S4; Figure 3C) were not within normal limits.
The whole therapeutic process including treatment strategy, efficacy and side effects.
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This condition is mainly due to the side effects of drugs. Treatment ended owing to subjective and objective reasons. The patient is still being followed-up. The therapeutic process is shown in Figure 4.