CASE REPORT article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1625918
This article is part of the Research TopicBrain Metastasis and Systemic Target Therapy: Implications for NeurosurgeonsView all 4 articles
Pathological complete response to conversion therapy for lung adenocarcinoma with brain metastasis: a case report
Provisionally accepted
- Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Lung cancer is the leading cause of cancer mortality worldwide. Fortunately, the advent of precision medicine, which includes targeted therapy and immunotherapy, significantly improves the survival rates of patients with locally advanced lung cance. This article reports a case of stage IVB (cT2bN1M1c1) non-small cell lung cancer (NSCLC) with brain metastases harboring compound mutations in epidermal growth factor receptor (EGFR) exon 21 Leu858Arg and mitogen-activated protein kinase (MEK1) exon 3 lle112Thr and high Programmed death ligand 1 (PD-L1) expression that successfully underwent radical lung cancer surgery following combined therapy. We report a case of a 60-year-old male diagnosed preoperatively with stage IVB adenocarcinoma of the left upper lung (cT2bN1M1c1), who was diagnosed with multiple brain metastases. After multidisciplinary discussion, it was decided to administer targeted therapy with furmonertinib, chemotherapy with pemetrexed and lobaplatin, immunotherapy with tislelizumab. Following 2 months of treatment, the tumor assessment showed partial response (PR), and after 11 months assessment showed a partial response of all lung lesions and complete response of brain lesions, making the patient eligible for surgery. Finally, the patient underwent video-assisted thoracoscopic left upper lobectomy + mediastinal lymphadenectomy. Postoperative pathology confirmed complete response, and the patient continued adjuvant therapy with furmonertinib. For those with metastatic advanced NSCLC, systemic treatment involving chemotherapy plus immunotherapy and targeted therapy is expected to become one of the options. Moreover, it's likely to receive successful conversion surgery and achieve further efficacy after combined therapy.
Keywords: Lung Adenocarcinoma, brain metastasis, furmonertinib, Conversion therapy, Pathological complete response
Received: 09 May 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Ran, luo, Zhang and Fu. 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: yong mao Fu, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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