Case Report Severe NSCLC, APE/AMI, Malignant Effusions: Almonertinib + Bevacizumab: A Case Report
by Cailian Hu#, Hongjia Chen#, Kengliang Rao#, Li Chen*
Department of Respiratory Medicine, The First Affiliated Hospital, Jinan University, Guangdong, P. R China
#These authors contributed equally
*Corresponding Author: Li Chen, Department of Respiratory Medicine, The First Affiliated Hospital, Jinan University, Guangdong, P. R China
Received Date: 02 February 2026
Accepted Date: 07 February 2026
Published Date: 10 February 2026
Citation: Hu C, Chen H, Rao K, Chen L (2026) Severe NSCLC, APE/AMI, Malignant Effusions: Almonertinib + Bevacizumab: A Case Report. Ann Case Report. 11: 2525. https://doi.org/10.29011/2574-7754.102525
Abstract
Purpose: The management of elderly patients with severe lung cancer (SLC) presenting with poor performance status (PS) and multiple life-threatening complications remains a major clinical dilemma. This study aimed to evaluate the efficacy and safety of a comprehensive, multidisciplinary treatment strategy in this challenging patient population.
Methods: We present the case of an 88-year-old male with EGFR L858R-mutated lung adenocarcinoma who presented with acute pulmonary embolism (APE), bilateral malignant pleural effusion, and malignant pericardial effusion (PS score 4), subsequently suffering an acute myocardial infarction during hospitalization. A multidisciplinary regimen was initiated, comprising systemic therapy (almonertinib plus bevacizumab), local intracavitary infusion (endostar and cisplatin), and anticoagulation.
Results: This integrated approach resulted in significant tumor reduction, partial resolution of the pulmonary embolism, effective control of malignant effusions, and an improvement in PS score from 4 to 2. The patient was successfully discharged and remained stable at follow-up, with no significant adverse events observed during the treatment course.
Conclusions: This case demonstrates that a comprehensive strategy integrating novel targeted agents with aggressive local and supportive care can break the vicious cycle of disease progression in elderly SLC patients. It provides a practical management model aligned with the international consensus on severe lung cancer, challenging the notion of therapeutic futility in critically ill oncology patients.
Keywords: Almonertinib; Bevacizumab; Severe Lung Cancer; Pulmonary Embolism; Malignant Effusion.
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