# Triple-induction treatment for locally advanced non-small cell lung cancer: a case report of pathological complete response

## TL;DR

A 47-year-old patient with advanced lung cancer achieved a complete response after a triple-induction treatment combining radiotherapy, chemotherapy, and immunotherapy followed by surgery.

## Contribution

This case report presents a successful triple-induction treatment for locally advanced NSCLC resulting in a pathological complete response.

## Key findings

- The patient achieved a pathological complete response after triple-induction treatment.
- The treatment enabled R0 resection of a borderline resectable tumor.
- Triple-induction may be a promising option for selected patients with good performance status.

## Abstract

In patients with resectable stage III non-small cell lung cancer (NSCLC), induction chemoimmunotherapy followed by surgical resection has shown unprecedented rates of pathological response and event-free survival. However, a triple-induction including radiochemotherapy and immunotherapy followed by surgical resection has not been routinely established in clinical practice.

We report the case of a 47-year-old patient with stage IIIA NSCLC who was treated in a combined concept including induction concurrent radiochemotherapy, followed by 4 cycles of pembrolizumab and subsequent intrapericardial left-sided pneumonectomy. Histological analysis revealed a pathological complete response.

The case demonstrates that the combination of neoadjuvant chemo-, radio- and immunotherapy in advanced NSCLC may lead to a relevant down-staging and may enable a R0-resection of a borderline resectable tumor. However, the combination of four different treatment modalities requires resilience and a good performance status. A triple induction treatment may be a promising option for selected patients with locally advanced NSCLC and good performance status.