CASE REPORT article
Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1597110
This article is part of the Research TopicNovel anti-cancer drugs combination radio-immunotherapy strategy: new frontiers in cancer immunotherapyView all 6 articles
Long-Term Complete Remission with Immunotherapy in Advanced RET Fusion-positive NSCLC with Brain Metastases: A Case Report and Literature Review
Provisionally accepted
- Huzhou Central Hospital, Huzhou, China
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The rearranged during transfection (RET) fusion is a rare genetic alteration in non-small-cell lung cancer (NSCLC), and the presence of brain metastases significantly influences prognosis. We present a 59-year-old patient diagnosed with RET fusion-positive lung adenocarcinoma which had metastasized to the brain at the time of initial diagnosis, classified as stage IVB, cT3N3M1. Tumor biopsy immunohistochemistry showed PD-L1 positivity (10%). After three cycles of pemetrexed plus cisplatin (PC) regimen combined with camrelizumab (a PD-1 inhibitor), a partial response (PR) was observed through chest computed tomography (CT) and brain magnetic resonance imaging (MRI). The patient underwent whole brain radiotherapy (WBRT) with a total dose of 37.5 Gy over 15 fractions, followed by 3 cycles of the PC regimen plus camrelizumab. Complete remission (CR) was achieved during 30 months of maintenance therapy with pemetrexed plus camrelizumab. The most recent follow-up was in February 2025. Both chest CT and brain MRI continued to show CR, with no clear indications of metastases. During the course of immunochemotherapy, grade 1 bone marrow suppression, but no toxicity of grade 3 or above, was observed. NSCLC patients who have PD-L1 overexpression and RET fusion-positivity may respond well to immunotherapy. Combining radiotherapy with immunotherapy may enhance local control of brain metastases.
Keywords: RET fusion-positivity, NSCLC, Immunotherapy, Radiotherapy, brain metastases
Received: 20 Mar 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Shang, Qin and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shuangmei Zhang, Huzhou Central Hospital, Huzhou, China
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