PMC7292188_01
(a) The response of the metastatic lesions measured by CT examination and progress of sequence therapy of patient 1. The measurable major axis of metastatic lesions and the minor axis of LN metastasis were measured by CT examination at each time point. Each size measurement of the metastatic lesion was summed, and the rate of change from the baseline and numbers of IMDC risk score were assessed at each CT examination and were plotted on the line graph. Lung metastatic lesions were separated by laterality. The drugs used in the sequence therapies are indicated below the chart by time series. (b) The major axis of each right lung metastatic lesion was summed and plotted on the stacked bar chart. The CT examination showed that some of the metastatic lung lesions showed growth during cytokine therapy and regression during sorafenib therapy. However, during the second round of therapy with the TKI sunitinib, new lung metastatic lesions appeared and then regressed entirely with axitinib administration. (c) The major axis of left S1 + S2 lung metastasis was plotted on the stacked bar chart. The CT examination showed that the left S1 + S2 lung metastasis temporarily responded to the three TKIs and almost diminished with the administration of nivolumab. (d) The minor axis of left hilar LN metastasis was plotted on the stacked bar chart. The LN metastatic lesions appeared after two TKIs and were also resistant to the third TKI, axitinib. However, these lesions rapidly shrunk with the administration of nivolumab.
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A line chart indicating the rate of change in the measurable metastatic lesions, change in IMDC risk score, and progress of sequential therapies are shown in Figure 1a. These lesions were found to be sensitive to axitinib and therefore regressed in size when axitinib treatment was administered (Fig. 1b). A left lung S1 + S2 metastatic lesion responded to the three TKIs but never diminished (Fig. 1c). During axitinib administration, a left hilar LN metastatic lesion developed (Fig. 1d) and another left S1 + S2 lesion also demonstrated regrowth (Fig. 1c).
PMC7292188_02
(a) The response of the metastatic lesions measured by CT examination and progress of sequence therapy of patient 2. Each size measurement of the metastatic lesion was summed, and rate of change from the baseline and IMDC risk score were assessed at each CT examination and were plotted on the line graph. (b) The major axis of each right and left lung metastatic lesion was summed and plotted on the stacked bar chart. (c) The minor axis of each right and left lung metastatic lesion was summed and plotted on the stacked bar chart.
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The rate of metastatic lesions and sequential therapies are shown in Figure 2a, and stacked bar charts of sum of the measurable lung metastasis and LNs are shown in Figure 2b,c.
PMC7292188_03
(a) The response of the metastasis measured by CT examination and progress of sequence therapy of patient 3. Each size measurement of the metastatic lesion was summed and rate of change from the baseline and numbers of IMDC risk score were assessed at each CT examination and were plotted on the line graph. (b) The minor axis of right paratracheal LN measured by CT examination was plotted by bar chart. (c) The major axis of thyroid metastasis measured by CT examination was plotted by bar chart. (d) The major axis of each lung metastasis in the right and left lung measured by CT examination was summed and plotted by stacked bar chart.
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The rate of metastatic lesions and sequential therapies was shown in Figure 3a. Approximately 2 months later, the CT showed that the metastatic lesions had decreased in size (Fig. 3b-d).