Clinical experience with the use of combination drug therapy in the first line treatment of metastatic non-small cell lung cancer

Background. Lung cancer occupies a leading place in the structure of morbidity and mortality from cancer in Russia and in the world. Non-small cell lung cancer (NSCLC) accounts for about 85% of cases among all lung malignancies; 42.2% of lung cancer cases in Russia were detected at the most advanced stage IV. Today, the optimal first-line treatment for patients with stage IV NSCLC without driver mutations, regardless of the level of PD-L1 expression, includes combination treatment regimens, representing by various combinations of chemotherapy, immune checkpoint inhibitors, and antiangiogenic therapy for the non-squamous histotype.

Description of a clinical case. A patient born in 1965 was under medical supervision with peripheral cancer of the upper lobe of the right lung, T1N0M0, stage I at the time of diagnosis, with relapse in the form of metastases in the supraclavicular, subclavian and bronchopulmonary lymph nodes 5 years after the atypical resection and subsequent rethoracotomy with upper lobectomy. Tumor control in the form of complete regression of lesions after three courses of combination therapy using an immune checkpoint inhibitor, cytotoxic drugs and an angiogenesis inhibitor with progression-free survival of more than a year was achieved. Tolerability of treatment was satisfactory.

Conclusion. The use of a combination with atezolizumab in patients with EGFR and ALK negative stage IV NSCLC who have not previously received therapy for advanced disease can significantly improve patient survival.