A case report of metastatic lung adenocarcinoma with long-term survival for over 11 years. Issue 4 (January 2019)

• Record Type: Journal Article
• Authors: Matsuzaki, Tatsu; Iwami, Eri; Sasahara, Kotaro; Kuroda, Aoi; Nakajima, Takahiro; Terashima, Takeshi
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 98:Issue 4(2019)
• Publication Date: 2019-01
• Subjects: adenocarcinoma -- EFGR-TKIs -- EGFR gene mutation -- long-term survival -- non-small cell lung cancer -- re-challenge chemotherapy -- T790 M; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000014100
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: This is the first known report in the English literature to describe a case of metastatic non-small cell lung cancer that has been controlled for >11 years. Patient concerns: A 71-year-old man visited our hospital because of dry cough. Diagnosis: Chest computed tomography revealed a tumor on the left lower lobe with pleural effusion, and thoracic puncture cytology indicated lung adenocarcinoma. Interventions: Four cycles of carboplatin and docetaxel chemotherapy reduced the size of the tumor; however, it increased in size after 8 months, and re-challenge chemotherapy (RC) with the same drugs was performed. Repeated RC controlled disease activity for 6 years. After the patient failed to respond to RC, erlotinib was administered for 3 years while repeating a treatment holiday to reduce side effects. The disease progressed, and epidermal growth factor receptor ( EGFR ) gene mutation analysis of cells from the pleural effusion detected the T790 M mutation. Therefore, osimertinib was administered, which has been effective for >1 year. Outcomes: The patient has survived for >11 years since the diagnosis of lung cancer. Lessons: Long-term survival may be implemented by actively repeating cytotoxic chemotherapy and EGFR-tyrosine kinase inhibitor administration.