Efficacy of a personalized combination regimen combining induction chemotherapy, immunotherapy, radiotherapy, and targeted therapy for locally advanced synchronous multiple primary lung cancer: a case report.

BACKGROUND: Multiple primary lung cancer is becoming increasingly common in clinical practice. It is divided into synchronous multiple primary lung cancer and nonsynchronous multiple primary lung cancer on the basis of a diagnostic interval of 6 months. However, the diagnosis and treatment of multiple primary lung cancer face great challenges in clinical practice. CASE PRESENTATION: We report a case of a 66-year-old Chinese male patient with locally advanced synchronous multifocal lung cancer. In M 0 months (the time of initial diagnosis), the patient underwent two cycles of carboplatin combined with albumin-bound paclitaxel induction chemotherapy before treatment was suspended due to personal reasons. In M + 10 months, he resumed a personalized multimodal treatment regimen: induction chemotherapy combined with immunotherapy, concurrent chemoradiotherapy combined with targeted therapy, and adjuvant immunotherapy combined with targeted maintenance therapy. As of M + 72 months, positron positron emission tomography-computed tomography showed lung metastasis, but his Karnofsky Performance Status score remained at 80, and he achieved progression-free survival of 72 months. He continues to receive chemotherapy, tislelizumab immunotherapy, and recombinant human endothelin (Endostar) targeted therapy. As of M + 75 months, he has survived for 75 months without reaching the overall survival endpoint. CONCLUSION: Clinical practice should adopt a multidisciplinary treatment-based approach, integrating clinical information, imaging data, histopathological features, and molecular characteristics to formulate individualized clinical management strategies and treatment plans. Such personalized therapeutic approaches are essential to improving long-term survival rates and quality of life in patients with synchronous multifocal lung cancer.