An Advanced IVB Lung Adenocarcinoma Patient With KRAS Mutations, Benefited From Camrelizumab Combined With Anti-Angiogenic Agents for Therapy: A Case Report.

BACKGROUND: Although the presence of Kirsten murine sarcoma virus (KRAS) mutations predicts a failure of non-small cell carcinoma (NSCLC) patients to benefit from epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) therapy it may be more sensitive to programmed combination therapy of programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors + anti-angiogenesis. Recent treatment guidelines and clinical studies related to adenocarcinoma in NSCLC have indicated that in patients with inoperable stage IV lung adenocarcinoma, immune checkpoint inhibitors in combination with anti-angiogenic drugs may exert a synergistic effect and significantly improve the efficacy of near-term treatment, but quantification and long-term follow-up of specific clinical indicators are still lacking. No previous cases of long-term good results with camrelizumab combined with anti-angiogenic agents for KRAS-mutated NSCLC have been described.

CASE: This manuscript reports a case of a patient with advanced NSCLC with pleural effusion and KRAS mutations treated poorly with conventional chemotherapy who had long-term (more than 18 months) benefit with immunotherapy combined with an anti-angiogenic inhibitor in Shanghai General Hospital. In this case, pharmaceutical care of the patient was carried out through therapeutic drug adjustment, compliance, efficacy assessment, and safety evaluation to provide a reference for improving the efficacy and safety of drug therapy in clinical practice. As of the last follow-up date (December 2023), overall survival was 27 months, and the patient is currently in good general condition with no significant complaints of discomfort.

CONCLUSION: ICLs in combination with antiangiogenic therapy may be a therapeutic option for patients with KRAS mutations in advanced non-small cell lung cancer with good persistence.