PMC9393753_01
PET-CT at baseline 1 month before dabrafenib/trametinib treatment. PET-CT scan of the chest at baseline prior to dabrafenib plus trametinib therapy demonstrated a nodule in the upper left lung with elevated uptake of 18F-fluorodeoxyglucose (FDG), accompanied by enlargement of multiple lymph nodes of the left lung hilum as well as mediastinum (4L, 5, 6). No other lesions with elevated uptake of 18F-FDG were found.
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PET-CT revealed a nodule in the upper left lung (23 mm x 19 mm), accompanied by enlargement of multiple lymph nodes of the left lung hilum as well as mediastinum (4L, 5, 6) ( Figure 1 ).
Computed tomography imaging showed initial response to combination of dabrafenib and trametinib. Left column: CT scan of the chest at baseline 1 month prior to dabrafenib plus trametinib therapy demonstrated a nodule in the upper left lung (lung window) accompanied by enlargement of multiple lymph nodes of the left lung hilum as well as mediastinum (mediastinal window). Right column: CT scan at 2 months after therapy demonstrated a marked response with a significant decrease in the nodule, left lung hilum, and mediastinum.
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Two months later, at the first radiological assessment, his chest CT scan showed partial remission (PR) ( Figure 2 ).
Histopathological assessment of tumor regression. (A-C) Pathological picture prior to dabrafenib plus trametinib therapy. (D-F) Pathological picture post dabrafenib plus trametinib therapy. (A) demonstrated moderately differentiated adenocarcinomas. (D) demonstrated marked necrosis and massive benign fibrous tissue proliferation with very few residual tumor cells in resected tumor. (B) and (E) showed PD-L1 90% (B) and 5% (E) before and after dabrafenib plus trametinib therapy. (C) and (F) showed Ki67 35%(C) and 1%(F) before and after dabrafenib plus trametinib therapy. Original magnification: (A-F): x200.
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Postoperative pathological analysis showed major pathologic response for the tumor ( Figure 3 ), and all 14 lymph nodes resected (station 4L, 5, 7, 10, 11, 12) ( Figure 4 ) were negative.
Histopathological assessment of lymph nodes resected. Pathological pictures of lymph nodes station 4L(A), station 5(B), station 7(C), station10 (D), station 11(E), station 12(F). Original magnification: (A-F): x200.
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Postoperative pathological analysis showed major pathologic response for the tumor ( Figure 3 ), and all 14 lymph nodes resected (station 4L, 5, 7, 10, 11, 12) ( Figure 4 ) were negative.
Brief summary of the therapeutic process.
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The therapeutic process is shown in  Figure 5 .