PMC8531585_01
(A) Schematics show the treatment history of the patient. Enhanced computed tomography scan reveals the clinical response to chemotherapy, radiotherapy, nivolumab alone, and nivolumab combined with anlotinib. Red arrows point to the masses in pulmonary and lymph node metastases. (B) Immunohistochemistry presents the programmed death ligand-1 expression of the lymphoepithelioma-like carcinoma (LELC) tissues in pulmonary LELC. (C) The genetic testing result of the new metastatic lymph node in our patient, when her disease progressed after nivolumab monotherapy. (D) The curves showed serum tumor marker CYFRA21-1 levels before and after the combined nivolumab and anlotinib therapy. (E) The curves showed Epstein-Barr virus copy numbers in the serum before and after the combined nivolumab and anlotinib therapy.
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Regular examination suggested that nivolumab combined with anlotinib was effective until May 2020 ( Figure 1 ).