非小细胞肺癌（NSCLC）患者中有一半年龄超过70岁，由于耐受性差并且在大多数临床试验中被排除，治疗选择有限。安乐腾（Anlotinib hydrochloride）是一种新型口服多靶点酪氨酸激酶抑制剂，已获得中国标准第三线NSCLC治疗的批准。在此我们报道一个无驱动基因突变的老年NSCLC患者，他接受安乐腾作为一线治疗并取得了长期生存。这位77岁的男性患者因进行了一个星期的体力活动后出现胸闷被送入医院。患者被诊断为IIIB期驱动基因阴性鳞状细胞肺癌。之后他接受了为期2年10个月的安乐腾治疗，从第一次诊断到最后一次疾病进展。简单来说，他首先进行了6个疗程的铂基化疗联合安乐腾治疗。接着再进行6个疗程的安乐腾单药维持治疗，随后出现疾病进展。之后，采用安乐腾联合替加氟治疗，再次控制了疾病。在安乐腾联合替加氟疗程的29个周期之后，这位患者的病情最终进展。在安乐腾作为一线治疗的34个月中，该患者实现了无进展生存。目前，他的状态良好（表现状态评分为1）。这位患者采用安乐腾与化疗联合作为一线治疗方案实现了长期生存。版权所有©2023 Wang、Li、Zhou、Qiu、Zhang、Sun和Li。

Half of the population of non-small cell lung cancer (NSCLC) patients are older than 70 years and have limited therapeutic options due to poor tolerance and being excluded in most clinical trials. Anlotinib hydrochloride, a novel oral multi-target tyrosine kinase inhibitor, has been approved for the standard third-line treatment for NSCLC in China. Herein we report an elderly NSCLC patient without any driver gene mutations who was undergoing anlotinib as a front-line treatment and who achieved long-term survival.The 77-year-old male patient was admitted to the hospital for chest tightness after engaging in physical activity for a week. The patient has been diagnosed with stage IIIB driver gene-negative squamous cell lung carcinoma. After that, he was treated with anlotinib for 2 years and 10 months from the first diagnosis until the last disease progression. Briefly, anlotinib combined with platinum-based chemotherapy was performed as the first-line therapy over six cycles. After 6 more cycles of anlotinib monotherapy maintenance, disease progression occurred. Then, anlotinib combined with tegafur was administered as a salvage treatment, and the disease was controlled again. After 29 cycles of anlotinib combined with tegafur regimens, the disease progressed finally. The patient achieved a total of 34 months of progression-free survival after anlotinib was used as the front-line treatment. He is still alive with a good performance status now (performance status score: 1).This patient achieved long-term survival using anlotinib as a front-line regimen combined with chemotherapy.Copyright © 2023 Wang, Li, Zhou, Qiu, Zhang, Sun and Li.