Durable Clinical Remission in a Patient with Metastatic Lung Adenocarcinoma Treated with a Four-Drug Regimen Combining Chemoimmunotherapy and Anti-Angiogenic Therapy: A Case Report

This article presents a clinical case of a 66-year-old patient with stage IV metastatic adenocarcinoma of the right lung (T3N1M1bra) with an initial brain metastases. According to reviews of articles based on real-world clinical practice, patients typically have a very short median overall survival. In this patient, the tumor was characterized by the absence of driver alterations, including EGFR and BRAF mutations and ALK and ROS1 rearrangements, as well as low PD-L1 expression (TPS<1%). The patient received treatment with the combination of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP). After six cycles of chemoimmunotherapy and subsequent prolonged maintenance therapy with atezolizumab and bevacizumab, disease stabilization was achieved, with a duration of response exceeding 4 years (71 cycles of immunotargeted therapy). This case demonstrates that ABCP combination therapy can provide a durable clinical response even in patients with unfavorable prognostic molecular and genetic features, including PD-L1-negative status, and advanced non-small cell lung cancer with central nervous system involvement.