Exploration of genetic characterization in hyperprogressive disease after immunotherapy retreatment in a patient with LCNEC: A case report

Figures & data

Figure 1. Case study of a LCNEC patient with HPD during immunotherapy.

(a) CT scans were performed 15 weeks before starting serplulimab treatment (column 1), at baseline (PETCT scans were performed 5 weeks before starting serplulimab, column 2), and at first evaluation (MRI scans were performed 4 weeks after starting serplulimab, column 3). Lines 1 and 2 revealed the changes in right adrenal gland and liver, respectively. New liver lesions appeared. The red arrows indicate tumor lesions. (b) Rate of change in growth pattern in the patient, who developed HPD to serplulimab. Compared with the tumor image (−15 weeks), the tumor lesions at baseline (−5 weeks) and at first evaluation (4 weeks after starting immunotherapy) showed approximately 33% and 227% increases (145% increase compared with baseline imaging), respectively; 3.4-fold increase in progressive pace compared with pre-serplulimab. (c) Changes in tumor-associated antigens before and after serplulimab. NSE, neuron-specific enolase. (d) Patient treatment chart.

Table 1. Genomic alterations in specimens before atezolizumab and serplulimab.

Timelines	Before atezolizumab (First surgery)	Before serplulimab (Second surgery)
gene	Alteration type	Alteration type
FAT4	exon1, R11G, SNV	exon2, R11G, SNV
SMARCA4	exon19, V855D, E861*, SNV	exon18, V855D, SNV
		exon18, E861* exon18 SNV
CYLD	exon10, M462I, SNV	exon9, M462I, SNV
CTNNB1		exon10, V541L, SNV
KIT		exon9, N463S, SNV

Data availability statement

Data sharing is not applicable to this article.