PMC10350420_01
Timeline of response to TKI treatment. This figure shows the timeline of progression after 66 Days under the treatment with only Osimertinib and the patient succumbed to death after 17 Days under combination therapy.
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Chest CT (computed tomography) scanning showed a 4.3*3.7 cm mass beside the mediastinum of the left lung and a small amount of fluid accumulated in the left thoracic cavity (Figure 1). RECIST criteria (Figure 1). After 2 months, radiological progression was demonstrated with an increase in size (5.9*5.5 cm) and in pleural effusion. Rebiopsy or liquid biopsy was suggested to explore the resistance mechanism of osimertinib, but the patient refused because of advanced age and high price. Therefore, she received a combination of osimertinib 80 mg once daily and crizotinib 250 mg twice a day (Figure 1).
Representative images of H&E staining and immunohistochemistry. (A) H&E staining of the lung biopsy showed NSCLC. (B and C) Immunohistochemistry showed positive TTF-1 (B) and Napsin A (C).
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A biopsy specimen taken by CT-guided fine-needle aspiration (FNA) showed lung adenocarcinoma with positive TTF-1 and Napsin A and negative P40 and CK5/6 (Figure 2).