PMC10117841_01
Hematoxylin and eosin staining photomicrographs of a right lung tumor tissue biopsy. (A) Magnification, x200. (B) Magnification, x400.
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The histopathological analysis of the tissue biopsy samples collected from the right lung revealed poorly differentiated squamous cell carcinoma ( Figure 1 ).
Conversion of chest computed tomography at different times. (A and a) Baseline findings on chest computed tomography (tumor size: 52 x 55 mm). (B and b) The mass shrank significantly (tumor size: 31 x 18 mm) after treatment with four cycles of anlotinib plus cisplatin. (C and c) Stable disease (tumor size: 25 x 21 mm) following 12 cycles of anlotinib + tegafur. (D and d) Progressive disease (tumor size: 41 x 34 mm) after 29 cycles of anlotinib + tegafur.
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The chest scan first computed tomography (CT) result showed a mass which was 52 mm x 50 mm in size ( Figure 2A ). As per the solid tumor version 1.1 (RECIST 1.1) response evaluation criteria, the maximum lesion reduction reached 40.4% after four cycles of anlotinib with platinum-based chemotherapy ( Figure 2B ). Then, after 12 cycles of anlotinib in combination with tegafur, the lesion reduction reached 13.8% compared with the previous best curative effect ( Figure 2C ). On May 24, 2021, the lesion enlarged by 41.4%, and the efficacy was evaluated as disease progression ( Figure 2D ), so the patient's PFS2 was 24 months. The last follow-up was on December 12, 2022, and the CT result showed that the lesion size was 78 mm x 59 mm, which increased from the original diagnosis of 52 mm x 50 mm in size (Figure 2A).
Timeline of events from diagnosis to progressive disease and summary of the administered treatments. Treatment work flow from [(anlotinib + NDP) a (anlotinib + DDP)] (6 cycles) to(anlotinib) (6 cycles) and to (anlotinib + tegafur) (29 cycles). After undergoing this treatment strategy, the patient has achieved a PFS of 34 months and an OS of 53 months. These results surpass those seen in the majority of real-world studies and clinical trials.
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Afterwards, the regimen was switched to anlotinib (12 mg, d1-d14, q3w) combined with tegafur (120 mg d1-d14, q3w) ( Figure 3 ).