PMC8810527_01
Timeline of the disease course. (A) Previous treatment modalities. (B) Third metastatic line regimen with pembrolizumab plus chemotherapy.
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Afterwards, he received a double maintenance treatment with pembrolizumab and pemetrexed every 3 weeks, with a total of 8 cycles administered every 3 weeks until August 2021 ( Figure 1 ).
Thoracic (top) and pelvic (middle) transaxial images and whole-body PET/CT (bottom) illustrating the morphometabolic evolution. From left to right on each image: PET/CT 11/26/2020: baseline; PET/CT 04/16/2020: partial response; PET/CT 06/18/2020: maintenance of partial response with very discrete bone progression; PET/CT 08/23/2020: left pleural, soft tissues and bone morphometabolic progression. Blue arrows: soft tissue involvement; greens arrows: pleura involvement; red arrows: bone involvement.
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Unfortunately, the PET/CT performed at this time showed a dissociated response with a multimetastatic progression (on the left pleura, right adrenal gland, retroperitoneum, and various bone sites) despite the stability of the antero-superior mediastinal mass ( Figure 2 ).