Chunmao Wang, Haijie Cheng, Zitong Wang, Zhi Yang
Department of Thoracic Surgery, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, No. 9 Beiguan Street, Tongzhou District, Beijing, 101149, China.
J Cardiothorac Surg. 2024 Oct 1;19(1):554. doi: 10.1186/s13019-024-03092-0.
This case report details the successful treatment of a 68-year-old male patient with locally advanced RET-rearranged lung adenocarcinoma using neoadjuvant pralsetinib. The patient initially presented with a suspicious right upper lobe nodule, which was later diagnosed as lung adenocarcinoma following genetic testing that revealed a RET exon 12 fusion. After 2 months of neoadjuvant treatment with pralsetinib, a significant radiological response was observed, with a reduction in tumor size and metabolic activity. Subsequently, the patient underwent video-assisted thoracoscopic right upper lobectomy and mediastinal lymph node dissection. Postoperative pathological analysis revealed a major pathological response, with only 5% residual tumor cells in the primary lesion and no viable tumor cells in the lymph nodes. Postoperative pathological staging of TNM was ypT1aN0M0, stage IA1(AJCC, 8th edition). The patient recovered well after surgery, demonstrating the potential efficacy of neoadjuvant pralsetinib in locally advanced RET-rearranged lung adenocarcinoma. However, further clinical validation is required to establish the role of neoadjuvant targeted therapy and postoperative adjuvant therapy in this patient population.
本病例报告详细介绍了一名68岁男性局部晚期RET重排肺腺癌患者使用普拉替尼新辅助治疗的成功案例。患者最初表现为右上叶可疑结节，经基因检测显示RET外显子12融合，随后被诊断为肺腺癌。在接受2个月的普拉替尼新辅助治疗后，观察到显著的放射学反应，肿瘤大小和代谢活性均有所降低。随后，患者接受了电视辅助胸腔镜右上叶切除术和纵隔淋巴结清扫术。术后病理分析显示主要病理反应，原发灶仅残留5%的肿瘤细胞，淋巴结未见存活肿瘤细胞。TNM术后病理分期为ypT1aN0M0，IA1期（AJCC第8版）。患者术后恢复良好，显示了普拉替尼新辅助治疗在局部晚期RET重排肺腺癌中的潜在疗效。然而，需要进一步的临床验证来确定新辅助靶向治疗和术后辅助治疗在该患者群体中的作用。
