Long-Term Continuation therapy with Nab-Paclitaxel and Bevacizumab ± Anti-PD-1 in Advanced NSCLC: Case Reports and Mechanistic Insights：case report

Abstract

Background. The role of nab-paclitaxel in non-small cell lung cancer (NSCLC) maintenance therapy remains underexplored, particularly in combination with anti-angiogenic agents and immunotherapy. We present two cases of advanced NSCLC achieving prolonged progression-free survival (PFS) with nab-paclitaxel-based regimens. Case presentation. Case 1 (ALK-positive) received nab-paclitaxel+ bevacizumab every 4 weeks for more than 48 months. Case 2 (driver-negative) received nab-paclitaxel + bevacizumab + toripalimab every 6–8 weeks for 24 months. Both patients maintained partial regression disease, minimal toxicity (no grade ≥3 adverse events), and preserved quality of life. Conclusion. The literature review highlights synergistic mechanisms of chemotherapy, anti-angiogenesis, and immunotherapy, supported by trials such as IMpower150 and KEYNOTE-407. Low-dose, extended-interval nab-paclitaxel combined with anti-angiogenesis and immunotherapy may offer a feasible maintenance strategy, warranting validation in prospective trials.