Long-Term Survival After Salvage Thoracic Surgery on a Patient with ALK-Rearranged Metastatic Lung Adenocarcinoma After Progression on Targeted Therapy

Figures & data

Figure 1 PET-CT/CT scans of the primary lung tumor and hip bone lesion. Chest CT scans of the primary lung tumor prior to first-line treatment (A), after first-line treatment (B), and after second-line treatment (C); Pelvis CT scans of the hip bone lesion prior to first-line treatment (D and G), after first-line treatment (E), and after second-line treatment (F); PET-CT scans of the primary lung tumor in Apr 2018 (H) and Jan 2020 (J); PET-CT scans of the metastatic lesion to left hip joint in Apr 2018 (I) and Jan 2020 (K). Red arrows indicated the primary lung tumors and blue arrows indicated the hip bone lesions.

Abbreviation: PET-CT, positron emission tomography-computerized tomography.

Figure 2 Diagram presentation of multimodal treatment described in this report. The patient underwent three lines of therapies that consisted of radiotherapy, ALK inhibitor crizotinib, and surgery, with molecular monitoring. Notably, salvage thoracic surgery was performed after progression on second-line treatment based on crizotinib and was followed by a remarkable PFS of 31 months at last follow-up.

Abbreviations: ctDNA, circulating tumor DNA; PR, partial response; PFS, progression-free survival; SD, stable disease.