Case Report: Pathologic complete response in a patient with simultaneous diagnoses of resectable NSCLC and myeloid neoplasm with PDGFRA rearrangement treated with concurrent neoadjuvant chemoimmunotherapy and imatinib: translating clinical trial data to real-world practice

Neoadjuvant chemoimmunotherapy has become an established treatment approach in resectable non-small cell lung cancer (NSCLC). The utilization of neoadjuvant immune checkpoint blockade (ICB) and coordination of care in the real-world setting present important challenges, with limited data available f...

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Main Authors: Chad B. Sussman, Minal Shah, Kausha Amin, Rachel Fanaroff, Eric Krause, Vu H. Duong, Samuel Rosner
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1589126/full
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Summary:Neoadjuvant chemoimmunotherapy has become an established treatment approach in resectable non-small cell lung cancer (NSCLC). The utilization of neoadjuvant immune checkpoint blockade (ICB) and coordination of care in the real-world setting present important challenges, with limited data available for patients with multiple synchronous primary malignancies. This case describes a 57-year-old man with simultaneous diagnoses of resectable stage IIIA NSCLC and PDGFRA-rearranged myeloid neoplasm who received neoadjuvant chemotherapy and nivolumab in combination with imatinib prior to definitive resection. The treatment course was uncomplicated, resulting in a complete pathologic response and resolution of the eosinophilia. Our report highlights the decision-making involved in pursuing combined systemic therapy of the patient’s multiple malignancies and in navigating barriers related to tissue availability for biomarker testing. Approaches to neoadjuvant immunotherapy in early-stage NSCLC can be successful but must remain adaptable to reliably manage complex patient presentations in real-world, non-clinical trial settings.
ISSN:2234-943X