PMC10062446_01
Timeline of the patient's treatment history and plasma NGS results. EAR, EGFR, ALK, and ROS1; AP, pemetrexed plus cisplatin; NSCLC, non-small-cell lung cancer; SBRT, stereotactic body radiation therapy; SD, stable disease; ctDNA, circulating tumor DNA; PR, partial response; PD, progressive disease; NGS, next-generation sequencing.
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A 53-year-old Asian man, who is a heavy smoker, was diagnosed with lung adenocarcinoma in December 2013 and subsequently underwent R0 resection ( Figure 1 ).
Radiographical changes. (A) PET/CT scan shows the failure of AP+Bevacizumab treatment in March 2019. (B) CT scan shows the failure of toripalimab+paclitaxel in July 2019. CT shows a durable response to alectinib in December 2019 (C) and 2020 (D). (E) PD on ensartinib in February 2022. (F) CT shows a partial response to lorlatinib in December 2022. AP, pemetrexed plus cisplatin; PD, progressive disease; PET/CT, positron emission tomography/computed tomography.
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Then, toripalimab plus paclitaxel was initiated, achieving a PR at the first evaluation but developing into progressive disease (PD) at 3 months treatment ( Figures 2A, B ). Figures 2C, D ). Follow-up examination found an elevation of carcinoembryonic antigen (CEA) level. Chest CT and increased blood tumor markers revealed PD ( Figure 2E ). At the last follow-up date in December, clinical benefit is still ongoing ( Figure 2F ).