PMC7494390_01
Chest computed tomographic (CT) and positron emission tomography (PET) scans performed during pembrolizumab treatment. (A) Initial chest CT scan showed a consolidative mass (asterisk) and a small endobronchial mass in the left lower lobe (LLL, arrow), which was later identified as invasive mucinous adenocarcinoma. (B) Baseline PET scan showed hypermetabolic lesions in the LLL of the lung, mediastinal lymph nodes, spines, and ribs. (C) Chest CT scan, after three cycles of pembrolizumab monotherapy, showed a slight increase in both the LLL mass and endobronchial lesion. (D and E) Follow-up chest CT and PET scans after five cycles of treatment showed a marked enlargement of the LLL mass, aggravation of the previously identified metastatic lesions, and several newly developed spine metastases. (F) Next-generation sequencing showed that the tumor harbored STK11/TP53/KRAS compound mutations.
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The first response evaluation conducted in November 2019 showed slight increase in the size of primary tumor mass and the mediastinal lymph nodes (Figure 1C). Follow-up of patients with chest CT and PET scans conducted in January 2020 showed a marked enlargement of both the primary lung tumor and the mediastinal lymph nodes as well as several newly developed bone metastases (Figure 1D and E). STK11 (p.Y36fs*) genes (Figure 1F).