Metastatic SMARCA4-Deficient Lung Cancer Controlled for More Than Two Years With Tislelizumab and Fruquintinib

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Non-Small Cell Lung Cancer
Biomarkers
PD-L1 8%; no target-sensitive mutation identified
Sex
male
Spread to
left adrenal gland, cervical lymph nodes
Treatment
immunotherapy, targeted therapy and radiation
Outcome
Stable Disease

Treatment course, step by step

  1. Started tislelizumab with fruquintinib in April 2022 through a chemotherapy-free clinical trial.
  2. Fruquintinib was briefly stopped for arm pain and restarted at a lower dose.
  3. After cervical lymph-node progression in 2023, received local radiotherapy while systemic treatment continued.
  4. Stopped trial treatment in April 2024 after 2 years and moved to regular follow-up.

What happened, in summary

A 67-year-old man was diagnosed in March 2022 with SMARCA4-deficient non-small cell lung cancer after presenting with chest tightness. Imaging showed a left lower-lung tumor, extensive mediastinal lymph-node disease, and a left adrenal lesion considered metastatic. Tumor testing showed PD-L1 expression of 8% and no target-sensitive mutation.

He chose a chemotherapy-free clinical trial and began tislelizumab immunotherapy with the anti-angiogenic drug fruquintinib in April 2022. The tumor partially responded at the first follow-up and then remained stable. Arm pain led him to stop fruquintinib briefly, after which it was restarted at a lower dose.

In 2023, cervical lymph nodes enlarged and biopsy confirmed progression of the same lung cancer. He received local radiotherapy while continuing systemic treatment, which reduced the neck metastasis and improved his pain. Imaging on April 26, 2024 showed stable disease. After about 2 years on the trial, he chose to stop treatment and moved to regular follow-up.

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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