{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:01:57Z","timestamp":1785132117430,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1836904","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:41:31Z","timestamp":1785130891000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaoqian","family":"Zhai","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Lung Cancer Center, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongcheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Thoracic Oncology, West China Hospital, Sichuan University","place":["Chengdu, China"]},{"name":"Frontiers Science Center for Disease-related Molecular Networks, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manhua","family":"Wang","sequence":"additional","affiliation":[{"name":"West China School of Medicine, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenkun","family":"Liu","sequence":"additional","affiliation":[{"name":"Lung Cancer Center, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Department of Thoracic Surgery, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, 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