Case Report: Long-term TCR repertoire dynamics in a disease-free survival stage IIIB-N3 lung adenocarcinoma patient treated with anti-PD-1 followed by surgery

作者：Xiaoqian Zhai, Yongcheng Liu, Manhua Wang, Zhenkun Liu, Kaili Huang, X-D Wu, M Y Fan, Y Huang, Xinxia Gu, J LIU, Xuyu Cai, Ye Wang, Lu Jiang, Daxing Zhu · 发表于：Frontiers in Immunology · 年份：2026 · DOI：10.3389/fimmu.2026.1836904 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Diagnosis and Treatment、Lung Cancer Treatments and Mutations

Immune checkpoint blockade (ICB) therapy has dramatically improved the survival outcomes of patients with locally advanced unresectable and metastatic non-small cell lung cancer (NSCLC). In particular, accumulated clinical trials and systematic reviews have further verified that induction ICB regimen following surgery confers superior benefits for IIIB-N3 NSCLC. Herein, we present a clinical case of a patient diagnosed with bulky contralateral mediastinal N3 (cT1bN3M0) left upper lung adenocarcinoma and devoid of actionable driver gene alterations. The patient achieved pathological complete response following anti-PD-1 treatment and subsequently underwent left upper lobectomy, followed by anti-PD-1 therapy for three consecutive years. To date, the patient has maintained a recurrence-free survival status for more than 5 years. Notably, we dynamically monitored the T-cell receptor (TCR) repertoire throughout the entire treatment course. Further analysis of TCR profiles revealed distinct dynamic patterns of certain specific T-cell clonotypes during treatment. These clonal alterations may help interpret sustained immune responses and warrant further exploration as candidate indicators for therapeutic outcome.