# Stage IIIB ROS1-Positive NSCLC management: crizotinib + surgery + TCM achieves exceptionally prolonged PFS (a case report)

## TL;DR

A patient with aggressive lung cancer achieved a 62-month survival without disease progression using a combination of targeted therapy, surgery, and Traditional Chinese Medicine.

## Contribution

This case introduces a novel treatment strategy combining neoadjuvant targeted therapy, surgery, and TCM for long-term survival in ROS1-positive NSCLC.

## Key findings

- The patient achieved 62-month progression-free survival with no drug resistance or significant side effects.
- Combining neoadjuvant crizotinib, surgery, and TCM led to prolonged survival beyond standard treatment outcomes.
- The treatment approach showed potential for integrating Chinese-Western medicine in managing aggressive NSCLC.

## Abstract

This article reports a case of a patient with small primary foci (11 mm*8 mm), highly malignant ROS1 fusion-positive non-small cell lung cancer (NSCLC) with mediastinal and supraclavicular lymph node metastases. After neoadjuvant crizotinib targeted therapy, the patient underwent lobectomy and lymph node dissection. Postoperatively, continuous targeted therapy combined with Traditional Chinese Medicine (TCM) adjuvant intervention achieved an extremely prolonged 62-month progression-free survival (PFS) without drug resistance or obvious side effects, compared to the median real-world PFS (rwPFS) of approximately 20 months for guideline-recommended crizotinib treatment. The last follow-up in August 2025 showed the patient remained in good survival status. This case highlights a novel strategy of neoadjuvant targeted downstaging followed by surgical resection for small-lesion, highly invasive NSCLC, as well as the potential value of integrating postoperative Chinese-Western medicine management for long-term survival and treatment tolerance.