Achieving long-term survival in extensive-stage SCLC: a case report and mini literature review

Figures & data

Figure 1. Change in maximum tumor size by chest CT scans.

(A) CT image at the time of initial diagnosis. (B) Image after second line treatment. (C) Image after fourth line treatment. (D) Image after fifth line treatment. (E) Image after sixth line treatment. (F) Image after eighth line treatment. (G) Image during ninth line treatment.

Figure 2. HE and immunohistochemistry staining of tumor.

HE: hematoxylin-eosin; TTF-1: thyroid transcription factor-1. All images were shown at 400×.

Figure 3. Treatment timeline.

The efficacy evaluation was judged according to the Response Evaluation Criteria in Solid Tumours (RECIST) (Version 1.1).

EP: etoposide plus cisplatin; IP: irinotecan plus cisplatin; PR: partial response; PD: progressive disease; SD: stable disease.

Figure 4. Dynamic changes in peripheral blood lymphocyte subpopulations during the treatment.

Data were acquired using flow cytometry. CD19 represents B cells, CD16⁺CD56 represents natural killer cells, CD45 represents common leukocyte antigen, CD8 represents cytotoxic T cells, CD4 represents helper T cells, and CD3 represents total T cells. The y-axis represents the number of cells/ml of blood.

Table 1. The anti-cancer treatments of this patient.

Line of therapy	Treatments
First line	EP regimen was administered intravenously in a 21-day cycle for six cycles Etoposide, a fixed dose of 100 mg on days 1–5 of each cycle Cisplatin, a fixed dose of 120 mg on day 1 of each cycle
Second line	EP regimen was administered intravenously in a 21-day cycle for six cycles Etoposide, a fixed dose of 100 mg on days 1–5 of each cycle Cisplatin, a fixed dose of 120 mg on day 1 of each cycle
Third line	IP regimen was administered intravenously in a 21-day cycle for three cycles Irinotecan, 65 mg/m^2 on days 1 and 8 of each cycle Cisplatin, 75 mg/m^2 on day 1 of each cycle
Fourth line	Docetaxel monotherapy was administered intravenously in a 21-day cycle for four cycles Docetaxel, a fixed dose of 100 mg on day 1 of each cycle
Fifth line	Anlotinib monotherapy was administered orally daily for 7 months Anlotinib, 12 mg daily for 3 months, followed by a reduction to 8 mg daily for 4 months due to foot pain
Sixth line	Anlotinib was administered orally at 8 mg daily for 12 months Atezolizumab was administered intravenously at a fixed dose of 1200 mg on day 1 of every 21-day cycle for 14 cycles
Seventh line	Gemcitabine and sintilimab were administered intravenously at 1000 mg/m^2 and 200 mg on day 1 of every 21-day cycle for four cycles, respectively
Eighth line	Bevacizumab, temozolomide, and lobaplatin were administered intravenously in a 28-day cycle for seven cycles Bevacizumab, 15 mg/kg on day 1 of each cycle Temozolomide, 150 mg/m^2 on days 1–5 of each cycle Lobaplatin, 50 mg/m^2 on day 1 of each cycle
Ninth line	Serplulimab combined with EP regimen were administered intravenously in a 21-day cycle for six cycles Serplulimab, a fixed dose of 300 mg on day 1 of each cycle Etoposide, 100 mg/m^2 on days 1–3 of each cycle Cisplatin, 75 mg/m^2 on day 1 of each cycle