PMC9299059_01
pCR to neoadjuvant alectinib in resectable ALK-positive NSCLC. Contrast-enhanced CT of the chest before neoadjuvant therapy showed an approximately 4.2 x 3.4 cm mass in the right hilum with localized obstructive pneumonia in the right lower lobe (A) and enlarged R4 lymph node (B); Contrast-enhanced CT of the chest after neoadjuvant therapy showed an approximately 1.2 x 1.1 cm mass in the right hilum, with a tumor shrinkage of 90% (C) and 0.6 x 0.6 cm R4 lymph node, with a shrinkage of 50% (D); Contrast-enhanced CT of the chest at the 8-month follow-up showed no local replase (E,F).
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F1
Contrast-enhanced computerized tomography (CT) of the chest showed an approximately 4.2 x 3.4 cm mass in the right hilum with localized obstructive pneumonia in the right lower lobe and multiple enlarged lymph nodes in the right hilum and mediastinum (Figure 1).
Pathologic findings of this patient. (A), Bronchoscopic biopsy of the mass before treatment showed poorly differentiated pulmonary adenocarcinoma (H&E, x 100); (B), Immunohistochemical testing results (D5F3 assay) confirmed strong positivity of ALK (x 100); (C), Postoperative pathology showed pathological complete response, with a downstaging to ypT0N0M0 (H&E, x 100).
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F2
Mucosal biopsy of the infiltrated lesion at the opening of the basal and dorsal segments of the right lower lobe showed poorly differentiated pulmonary adenocarcinoma with a Ki-67 of 35% (Figure 2).
The timeline therapy administration from the episode of care. PR, partial response; pCR, pathological complete response.
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F3
The timeline therapy administration from the episode of care was shown in Figure 3.