Sure.
I structure my apps with light DOM vanilla web components, using lit-html (not lit) as a renderer.
I'll use a hypothetical patient profile component as an example. Let's say that it's a top level "page" and needs to support deep linking.
set patient_id(value) would trigger a loadPatient(). loadPatient would set this.patient when loading is complete. The setter for this.patient triggers a render and paints the component.
You can expand on that as needed. Maybe sometimes I want to render that component in a modal, maybe sometimes as a slide out drawer. Maybe there are little differences in the header or something depending on how it's being hosted - I can just add a setter for something like "display_mode" (making this up) that would trigger a render on change.
It's really no different than any reactive flow, and about the same as big frameworks when you count total LOC, but it's all just vanilla and simple.
For cross component communication, custom events work great, especially the one-shot ones. In a component constructor, I can add a listener, assign a property or call a component function, and the reactive flow just goes as normal.
No framework needed.
Works with any renderer, if you don't like lit-html, there are JSX and others out there. I like lit-html because it's super fast template node clones, so you don't need to worry about calling render() redundantly, it's cheap.