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.