Stage IV Lung Adenocarcinoma With KRAS Mutation Responding to Immunotherapy and Anti-Angiogenic Treatment

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Adenocarcinoma
Biomarkers
KRAS Q61H mutation; MET amplification
Sex
male
Spread to
pleura
Treatment
chemotherapy, immunotherapy, targeted therapy and radiation
Outcome
Responding Well

Treatment course, step by step

  1. Started cisplatin and pemetrexed with an anti-angiogenic treatment.
  2. After worsening pleural disease and malignant pleural effusion, treatment changed to cisplatin and docetaxel with camrelizumab and endostatin, and he also received 6 sessions of proton heavy-ion therapy.
  3. Continued camrelizumab with anti-angiogenic therapy, later switching from endostatin to bevacizumab.

What happened, in summary

A man was diagnosed in December 2020 with Stage IV lung adenocarcinoma after presenting with cough, sputum, chest tightness, pericardial fluid, and pleural effusion. Tumor testing identified a KRAS Q61H mutation and MET amplification.

He initially received cisplatin and pemetrexed with anti-angiogenic treatment. Within several months, pleural thickening and fluid increased, and he developed a malignant pleural effusion. His treatment was changed to cisplatin and docetaxel with camrelizumab immunotherapy and endostatin. He also received 6 sessions of proton heavy-ion therapy outside the treating hospital. After 12 cycles of immunotherapy, the anti-angiogenic component was changed from endostatin to bevacizumab while camrelizumab continued.

During treatment, a separate papillary thyroid cancer was discovered, but management focused on the more urgent lung cancer. By the December 2023 follow-up, the pleural effusion had disappeared, several tumor markers had returned to the normal range, and the primary lung tumor had not progressed. He was described as symptom-free and in good health while continuing maintenance therapy.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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