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Published on: June 26, 2019
Synchronous multiple primary lung cancers with different response to gefitinib
Baek-Yeol Ryoo1, Im Il Na, Sung Hyun Yang
1Department of Internal Medicine, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, Republic of Korea.
Lung Cancer (Amsterdam, Netherlands)
|June 22, 2006
Summary
This study reports a 66-year-old male smoker with synchronous lung cancers. Different tumor types responded uniquely to chemotherapy, suggesting distinct molecular drivers for each cancer.
Area of Science:
- Oncology
- Molecular Pathology
- Pulmonology
Background:
- Synchronous lung cancers present diagnostic and therapeutic challenges.
- Understanding the molecular basis of distinct tumor types is crucial for personalized treatment.
Observation:
- A 66-year-old male smoker presented with synchronous bronchiolo-alveolar cell carcinoma (BAC) in both lungs and squamous cell carcinoma in the left lung.
- Initial chemotherapy with gemcitabine and carboplatin showed partial resolution of squamous cell carcinoma but increased BAC extent.
- Second-line gefitinib improved BAC but worsened squamous cell carcinoma.
Findings:
- Epidermal growth factor receptor-tyrosine kinase (EGFR-TK) mutation analysis revealed a specific deletion (delE746-A750 in exon 19) in BAC.
- Squamous cell carcinoma lacked EGFR-TK mutations.
- Differential responses to chemotherapy suggest distinct molecular pathogenesis for the synchronous tumors.
Implications:
- Synchronous lung tumors can exhibit varied histological and molecular characteristics.
- EGFR-TK mutation status significantly influences treatment response in lung adenocarcinoma.
- This case highlights the importance of molecular profiling for guiding therapy in complex lung cancer presentations.
