What happened, in summary

A 68-year-old woman was diagnosed in July 2021 with Stage IV lung adenocarcinoma carrying an EGFR exon 19 deletion. She began osimertinib and achieved a partial response that lasted about 24 months.

When the lung cancer later progressed, a repeat biopsy showed a mixture of adenocarcinoma and small cell lung cancer. Testing also identified TP53 and RB1 mutations. She initially declined chemotherapy and chose anlotinib plus aumolertinib, but the main lung lesion progressed after four months.

She then received etoposide and cisplatin chemotherapy together with adebrelimab immunotherapy. The lung lesion shrank, while a cervical lymph-node metastasis enlarged and was confirmed as lung adenocarcinoma. Osimertinib was added back to address the mixed tumor biology. After two cycles of the combined regimen, both the lung lesion and cervical lymph-node metastasis decreased. At the last follow-up in February 2024, she was alive 32 months after diagnosis and responding to treatment.