Pancoast tumor, a special subtype of non-small cell lung cancer originating from the apex of the upper lobe, is characterized by its complex clinical manifestations and high treatment difficulty due to its unique anatomical location, often leading to a relatively poor prognosis. Currently, guidelines recommend neoadjuvant concurrent chemoradiotherapy followed by surgery as the standard treatment strategy, which has significantly improved overall patient survival compared to previous approaches. However, this regimen has limitations, including significant toxicity, increased surgical complexity, and a lack of individualized treatment options. In recent years, new strategies such as neoadjuvant targeted therapy and immunechemotherapy combinations have shown higher pathological response rates and manageable safety profiles in clinical studies, offering new directions for treating Pancoast tumors. This case report describes a 56-year-old female diagnosed with stage ⅢC Pancoast tumor harboring co-mutations in EGFR and ERBB2 and high PD-L1 expression. Through dynamic biopsy-guided precise targeted therapy, a neoadjuvant strategy incorporating immunotherapy and chemotherapy, and successful surgical intervention, pathological complete response was achieved. This case highlights the critical value of a multidisciplinary team approach and precision medicine in the management of Pancoast tumor.

BACKGROUNDRRM1 may be a prognostic factor in non-small cell lung cancer (NSCLC). The aim of this study is to evaluate RRM1 expression and prognosis in NSCLC by the means of tissue microarray.

METHODSA total of 417 paraffin-embedded specimens of NSCLC from Lung Cancer Study Center in Guangdong Provincial People's Hospital were collected and tissue microarray was constructed. RRM1 expression was detected by SP method and its correlation with prognosis was evaluated.

RESULTSNo statistic difference was found in RRM1 expression in different gender, age, tumor site, histology, differentiation, T stage, N stage, M stage and pTNM stage groups (P > 0.05). Univariate analysis showed that RRM1 was not an independent prognostic factor (P > 0.05). At the multivariate analysis, differentiation and N stage were considered independent prognostic factors.

CONCLUSIONSRRM1 expression detected by immunohistology is not an independent prognostic factor in NSCLC. TNM stage is still the best prognostic factor up to now.

Objective To study the genes which simultaneously participate in different carcinogenesis progression in lung adenocarcinoma for biomarkers identification. Methods 10 lung adenocarcinoma samples including pathologic stage Ⅰ,Ⅱ,Ⅲ were chosen for experiment and their matched normal tissues for control. After hybridization on 20 slides of microarray with 13824 genes, we analyze the expression profiles combined with pathologic stage and clinical prognosis by data mining. The genes differentially coexpressed in different stage and different prognosis samples were the target. Results 119 genes were identified. Among these targets, 26 genes have known to be related to lung cancer, 46 genes were unreported and 47 gene were new. Conclusions The 119 genes were very important during cancer occurrence and development and were the candidate biomarkers in lung adenocarcinoma.