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已发表论文
重新定义治疗界限：PD-1 阻断促进伴胸膜转移的 EGFR-TKI 耐药 EGFR 突变型非小细胞肺癌的手术治愈
Authors Niu YL, Teng XB, Han MF, Ma J
Received 27 June 2025
Accepted for publication 5 November 2025
Published 11 November 2025 Volume 2025:18 Pages 1259—1264
DOI https://doi.org/10.2147/OTT.S549874
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Sanjay Singh
Yong-Liang Niu,1,* Xiao-Bao Teng,1,* Ming-Feng Han,1,* Jie Ma2
1Department of Respiratory and Critical Care Medicine, No. 2 People’s Hospital of Fuyang City, Fuyang, Anhui, 236000, People’s Republic of China; 2Department of Thoracic Surgery, Anhui Chest Hospital, Hefei, 230022, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jie Ma, Department of Thoracic Surgery, Anhui Chest Hospital, Hefei, 230022, People’s Republic of China, Email majie1537@126.com
Abstract: We present a 57-year-old female diagnosed with stage cT3N1M1a (IVA) EGFR L858R-mutant lung adenocarcinoma (PD-L1 TPS 60%). The patient attained sustained disease control with a partial response lasting 22 months on first-line gefitinib. Following progression with persistent EGFR L858R mutation, second-line platinum-pemetrexed-bevacizumab chemotherapy achieved stable disease (SD) in the primary lesion and shrinkage of pleural nodules. Subsequent neoadjuvant therapy with albumin-bound paclitaxel, carboplatin, bevacizumab, and sintilimab induced marked tumor regression, permitting curative-intent R0 resection. Histopathological analysis confirmed ypT0N0, indicating a pathological complete response (pCR). The patient remained recurrence-free 25 months post-surgery. This case illustrates the potential of immunotherapy-based neoadjuvant regimens to convert unresectable PD-L1–high EGFR-mutant lung adenocarcinoma into operable disease and achieve durable pCR.
Keywords: EGFR-mutant lung adenocarcinoma, pathological complete response, immunotherapy conversion, sintilimab, neoadjuvant therapy
1Department of Respiratory and Critical Care Medicine, No. 2 People’s Hospital of Fuyang City, Fuyang, Anhui, 236000, People’s Republic of China; 2Department of Thoracic Surgery, Anhui Chest Hospital, Hefei, 230022, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jie Ma, Department of Thoracic Surgery, Anhui Chest Hospital, Hefei, 230022, People’s Republic of China, Email majie1537@126.com
Abstract: We present a 57-year-old female diagnosed with stage cT3N1M1a (IVA) EGFR L858R-mutant lung adenocarcinoma (PD-L1 TPS 60%). The patient attained sustained disease control with a partial response lasting 22 months on first-line gefitinib. Following progression with persistent EGFR L858R mutation, second-line platinum-pemetrexed-bevacizumab chemotherapy achieved stable disease (SD) in the primary lesion and shrinkage of pleural nodules. Subsequent neoadjuvant therapy with albumin-bound paclitaxel, carboplatin, bevacizumab, and sintilimab induced marked tumor regression, permitting curative-intent R0 resection. Histopathological analysis confirmed ypT0N0, indicating a pathological complete response (pCR). The patient remained recurrence-free 25 months post-surgery. This case illustrates the potential of immunotherapy-based neoadjuvant regimens to convert unresectable PD-L1–high EGFR-mutant lung adenocarcinoma into operable disease and achieve durable pCR.
Keywords: EGFR-mutant lung adenocarcinoma, pathological complete response, immunotherapy conversion, sintilimab, neoadjuvant therapy