{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:16:23Z","timestamp":1760058983647,"version":"build-2065373602"},"reference-count":6,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,18]],"date-time":"2025-05-18T00:00:00Z","timestamp":1747526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Tumor cavitation is distinguished by the emergence of central necrosis and cavity formation within the tumor mass, which indicates a notable outcome of anti-angiogenic therapies. This case describes a 52-year-old Chinese female with advanced EGFR-mutated lung adenocarcinoma (Exon 19 deletion), which was metastatic to bilateral lungs, brain, and right adrenal gland, who exhibited a radiographic response to combination therapy with the third-generation EGFR tyrosine kinase inhibitor (TKI) aumolertinib and the anti-angiogenic agent anlotinib. The patient achieved near-complete cavitation of almost all bilateral lung nodules, manifesting as distinctive \u201cbullet hole\u201d lesions on the chest CT. Despite this initial response, disease progression occurred two months later with new liver metastases, culminating in the patient\u2019s death. This case underscores the potential efficacy of EGFR TKIs and anti-angiogenic agents in inducing unique tumor microenvironment modifications, while highlighting the transient nature of such responses and the critical need to address resistance mechanisms. Tumor cavitation may serve as a radiographic marker of anti-angiogenic activity but does not preclude metastatic spread, necessitating vigilant monitoring even in the setting of favorable imaging changes.<\/jats:p>","DOI":"10.3390\/diagnostics15101280","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T03:51:03Z","timestamp":1747626663000},"page":"1280","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tumor Cavitation with Anlotinib Treatment in Lung Adenocarcinoma"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0381-1549","authenticated-orcid":false,"given":"Jie","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Thoracic Oncology, Hangzhou Cancer Hospital, No. 34, Yanguan Lane, Shangcheng District, Hangzhou 310002, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2299-6876","authenticated-orcid":false,"given":"Xueqin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology, Hangzhou Cancer Hospital, No. 34, Yanguan Lane, Shangcheng District, Hangzhou 310002, China"},{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University, Hangzhou 310006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s13045-018-0664-7","article-title":"Anlotinib: A novel multi-targeting tyrosine kinase inhibitor in clinical development","volume":"11","author":"Shen","year":"2018","journal-title":"J. Hematol. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1038\/nm0901-987","article-title":"Normalizing tumor vasculature with anti-angiogenic therapy: A new paradigm for combination therapy","volume":"7","author":"Jain","year":"2001","journal-title":"Nat. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e000111","DOI":"10.1136\/esmoopen-2016-000111","article-title":"Radiological imaging markers predicting clinical outcome in patients with metastatic colorectal carcinoma treated with regorafenib: Post hoc analysis of the CORRECT phase III trial (RadioCORRECT study)","volume":"1","author":"Ricotta","year":"2016","journal-title":"ESMO Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1097\/JTO.0b013e318168c7e9","article-title":"Tumor Cavitation During Therapy with Antiangiogenesis Agents in Patients with Lung Cancer","volume":"3","author":"Marom","year":"2008","journal-title":"J. Thorac. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.21037\/tlcr-24-465","article-title":"Tumor cavitation in patients with non-small-cell lung cancer receiving anti-angiogenic therapy with apatinib","volume":"13","author":"Cai","year":"2024","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s00432-019-03064-1","article-title":"Prognostic value of tumor cavitation in extensive-stage small-cell lung cancer patients treated with anlotinib","volume":"146","author":"Chen","year":"2020","journal-title":"J. Cancer Res. Clin. Oncol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/10\/1280\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:34:50Z","timestamp":1760031290000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/10\/1280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,18]]},"references-count":6,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["diagnostics15101280"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15101280","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,5,18]]}}}