What happened, in summary

A 62-year-old man developed a persistent dry cough and was found in July 2021 to have a very large tumor in the left lower lung. Biopsy showed a malignant spindle-cell tumor consistent with pulmonary sarcomatoid carcinoma, and the cancer was Stage III. Molecular testing found a ROS1 rearrangement and a TP53 mutation.

He started crizotinib because of the ROS1 alteration, but the tumor continued to grow and chest pain became severe. By November 2021 the mass had enlarged and invaded the pleura. PD-L1 expression was 0%.

He then received 2 cycles of tislelizumab combined with albumin-bound paclitaxel and cisplatin. Imaging showed a partial response and his chest pain improved. In February 2022 he underwent left lower lobectomy with systematic lymph-node dissection. Pathology found extensive treatment effect but no residual cancer, representing a complete pathologic response.

He received 2 more cycles of immunotherapy plus platinum-based chemotherapy after surgery. During follow-up, no recurrence was detected for more than 30 months.