# 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

## TL;DR

A patient with two cancers, lung and blood-related, achieved full recovery after receiving combined treatments before surgery, showing how clinical trial strategies can work in real-world settings.

## Contribution

Demonstrates successful real-world application of combined neoadjuvant chemoimmunotherapy and imatinib for dual malignancies with PDGFRA rearrangement.

## Key findings

- The patient achieved a complete pathologic response after treatment.
- Eosinophilia associated with the myeloid neoplasm resolved following therapy.
- Combined therapy was safely administered without major complications.

## Abstract

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.