Case Report: Ivonescimab in EGFR-mutant lung cancer with baseline malignant pleural effusion and acquired complex resistance.

ABSTRACT:

Background

Patients with epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma (LUAD) presenting with malignant pleural effusion (MPE) at diagnosis have a poor prognosis. Options are limited after EGFR-TKI resistance. Ivonescimab, a PD-1/VEGFA bispecific antibody, is effective in advanced non-small cell lung cancer, but its efficacy in patients with baseline MPE and complex acquired resistance remains unclear.

Case presentation

A 55-year-old man was diagnosed with LUAD and significant MPE, featuring an EGFR exon 19 deletion and over 20 co-mutations. The patient eventually developed resistance to both first-line gefitinib and later almonertinib. Repeat genomic testing of pleural fluid upon progression revealed persistent alterations in 12 genes, including the ori

SUBMITTER: Mo Z 

PROVIDER: S-EPMC12753922 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature