Purpose: Although the presence of Kirsten rat sarcoma virus (KRAS) mutations predicts of a lack of benefit from epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) therapy for none small cell cancer (NSCLC), it may be more sensitive to programmed combination therapy with cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors + anti-angiogenesis. Recent treatment guidelines and clinical studies related to adenocarcinoma in NSCLC have indicated that in patients with inoperable stage IV lung adenocarcinoma, immune checkpoint inhibitors in combination with anti-angiogenic drugs may exert a synergistic effect and significantly improve the efficacy of near-term treatment, but quantification and long-term follow-up of specific clinical indicators are still lacking. No previous cases of long-term good results with camrelizumab combined with anti-angiogenic agents for KRAS-mutated NSCLC have been described. Methods: This manuscript reports a case where patients with advanced NSCLC with pleural effusion and KRAS mutations treated poorly with conventional chemotherapy had long-term (more than 18 months) benefit with immunotherapy combined with an anti-angiogenic inhibitor. In this case, pharmaceutical care of the patient was carried out through therapeutic drug adjustment, compliance, efficacy assessment, and safety evaluation to provide a reference for improving the efficacy and safety of drug therapy in clinical practice. Results: As of the last follow-up date (December 2023), overall survival was 27 months and the patient is currently in good general condition with no significant complaints of discomfort. Conclusion: ICLs in combination with antiangiogenic therapy may be a therapeutic option for patients with KRAS mutations in advanced non-small cell lung cancer with good persistence.
