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Case Report Open Access

Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report

  • Authors:
    • Yinghui Bi
    • Chaoran Xia
    • Xinglin Zhang
    • Haixin Liu
  • View Affiliations / Copyright

    Affiliations: Department of Oncology, Qingdao Municipal Hospital, Qingdao, Shandong 266012, P.R. China, Zhejiang Shaoxing Topgen Biomedical Technology Co. Ltd., Shanghai 200120, P.R. China
    Copyright: © Bi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 407
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    Published online on: August 2, 2023
       https://doi.org/10.3892/ol.2023.13993
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Abstract

Ongoing investigations of targeted therapeutic agents and their increased clinical applications, together with research in genomics and proteomics, have explored a variety of novel approaches for treatment of lung cancer, and ‘molecular subtypes’ have been defined based on specific actionable genetic aberrations. Liquid biopsies, including circulating tumor DNA (ctDNA) testing, are of value for cancer diagnosis and comprehensive genomic profiling, such as the identification of cancer subtypes and major genetic alterations in cancer cells. The case of a 66‑year‑old male patient with newly‑diagnosed driver mutation‑negative advanced non‑small cell lung cancer (NSCLC) who underwent conventional therapy is described in the present report. The patient underwent regular monitoring, including continuous ctDNA analysis, imaging and assessment of tumor marker levels such as carcinoembryonic antigen (CEA). The patient initially presented with deep vein thrombosis which affected both lower extremities and without any symptoms in the lung, with a positron emission tomography scan identifying irregular pulmonary nodules in the right lower lobe and enlarged right supraclavicular lymph nodes. Subsequent ultrasound‑guided fine‑needle aspiration with nodule biopsy indicated advanced unresectable disease at stage IIIB based on the Tumor‑Node‑Metastasis staging system by the American Joint Committee on Cancer. Next‑generation sequencing of tumor tissue and peripheral blood confirmed driver mutation‑negative genes, including epidermal growth factor receptor, rat sarcoma, ALK receptor tyrosine kinase, ROS1 proto‑oncogene receptor tyrosine kinase and rearrangement during transfection (RET). After 5 years of chemoradiotherapy and surveillance of ctDNA and CEA levels, detectable kinesin family member 5B (KIF5B)‑RET fusion in ctDNA and rising CEA levels prompted early scans, which identified disease progression. The patient subsequently received the oral RET inhibitor pralsetinib, with treatment being currently ongoing for ≥17 months without detectable KIF5B‑RET ctDNA or elevated CEA levels, with an ongoing minor response and stable disease based on Response Evaluation Criteria in Solid Tumors v1.1 on imaging. The present case illustrates the potential role of on‑therapy circulating tumor biomarker monitoring as a non‑traumatic method to evaluate therapy response and detect early disease progression in patients with advanced NSCLC. Integration of circulating tumor biomarker testing into the management of patients with advanced NSCLC requires additional prospective studies to actively assess and elucidate optimal treatment strategies.
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Copy and paste a formatted citation
Spandidos Publications style
Bi Y, Xia C, Zhang X and Liu H: Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report. Oncol Lett 26: 407, 2023.
APA
Bi, Y., Xia, C., Zhang, X., & Liu, H. (2023). Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report. Oncology Letters, 26, 407. https://doi.org/10.3892/ol.2023.13993
MLA
Bi, Y., Xia, C., Zhang, X., Liu, H."Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report". Oncology Letters 26.3 (2023): 407.
Chicago
Bi, Y., Xia, C., Zhang, X., Liu, H."Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report". Oncology Letters 26, no. 3 (2023): 407. https://doi.org/10.3892/ol.2023.13993
Copy and paste a formatted citation
x
Spandidos Publications style
Bi Y, Xia C, Zhang X and Liu H: Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report. Oncol Lett 26: 407, 2023.
APA
Bi, Y., Xia, C., Zhang, X., & Liu, H. (2023). Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report. Oncology Letters, 26, 407. https://doi.org/10.3892/ol.2023.13993
MLA
Bi, Y., Xia, C., Zhang, X., Liu, H."Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report". Oncology Letters 26.3 (2023): 407.
Chicago
Bi, Y., Xia, C., Zhang, X., Liu, H."Targeted treatments after chemoradiotherapy failure in a patient with relapsed, advanced non‑small cell lung cancer with on‑therapy circulating tumor biomarker monitoring: A case report". Oncology Letters 26, no. 3 (2023): 407. https://doi.org/10.3892/ol.2023.13993
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