case_images: PMC10864638_01
case_images: Computed Tomographic (CT) scans (left lower lobe mass and liver metastases): (A) Before nivolumab/ipilimumab treatment. (B) After 42 days of nivolumab/ipilimumab treatment. (C) Before temsirolimus add-on. (D) After 90 days temsirolimus add-on (A, B) show when nivolumab/ipilimumab treatment resulted in a stable disease response for 7 weeks. (C) shows PD response 4 months after starting nivolumab/ipilimumab treatment. The largest liver lesion in (C) measured 88 mm in diameter at its longest. (D) shows significantly reduced lung and liver metastases 3 months after treatment with temsirolimus and nivolumab/ipilimumab.
case_images: fendo-15-1304188-g001.jpg
case_images: PMC10864638_01_fendo-15-1304188-g001.jpg
case_images: f1
case_images: The baseline sum of the target lesions was 18.1 cm, with the liver lesion measuring 3.8 cm (Figure 1A). Follow-up CT scan after two months showed stable disease with a sum of target lesion of 15 cm, and -17.1% change from baseline (RECIST 1.1; Figures 1A, B). Follow-up scans showed progression, with the sum of target lesions at 23.3 cm, a 55.3% increase from the previous CT (Figure 1C). CT scan also showed partial response with the sum of the target lesion of 15.1cm and a -35.2% change from previous CT (Figure 1D).
case_images: Sum of the LD of target lesions by RECIST (mm), serum thyroglobulin levels (ng/mL), mean ctDNA molecules (MTM) per mL of patient's plasma measured by tumor-informed circulating tumor DNA (ctDNA), variant allele fraction (VAF) of somatic mutations measured by plasma-only circulating tumor DNA (ctDNA) in the treatment course. After adding temsirolimus to nivolumab and ipilimumab, the patient's sum of the LD of target lesions, serum thyroglobulin level, and ctDNA measured by tumor informed ctDNA assay decreased remarkably. CBZ, cabozantinib; LD, longest diameters.
case_images: fendo-15-1304188-g002.jpg
case_images: PMC10864638_01_fendo-15-1304188-g002.jpg
case_images: f2
case_images: Circulating tumor DNA (ctDNA) was analyzed using two different assays (Figure 2).