Adenosquamous cell lung cancer successfully treated with gefitinib: A case report
Koichi Kurishima1, Gen Ohara1, Katsunori Kagohashi1
1Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan.
Abstract:
Although adenosquamous cell lung cancer (ASCLC) is included in the non-small-cell lung cancers (NSCLCs), the number of currently available studies on the response of this type of cancer to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) is limited. This is the case report of a 66-year-old female who was referred to the Mito Medical Center (Mito, Japan) with hemoptysis and the chest computed tomography (CT) scan revealed a large cavitary mass in the lower lobe of the left lung. The patient underwent surgical resection of the lesion and the final pathological diagnosis was ASCLC staged as pT2bN2M0. Notably, an EGFR exon 19 deletion was identified in the adenocarcinomatous as well as the squamous cell carcinomatous components of the tumor. Despite adjuvant chemotherapy, the patient developed small cavitary metastases in the lungs bilaterally. Therefore, treatment with gefitinib was initiated. The chest CT scan revealed substantial regression of the metastatic cavitary tumors in both lungs, with thinning of the walls. The patient remains alive and recurrence-free 19 months following the initiation of gefitinib therapy. This case demonstrated an optimal clinical response to gefitinib treatment for EGFR mutation-positive ASCLC, suggesting that gefitinib is a therapeutic option for such a subset of patients with ASCLC.
Insights
This case report highlights a patient with adenosquamous cell lung cancer (ASCLC) who responded well to gefitinib. The epidermal growth factor receptor (EGFR) mutation in the tumor suggests gefitinib is a viable treatment option for ASCLC.
Area of Science:
- Oncology
- Genetics
Background:
- Adenosquamous cell lung cancer (ASCLC) is a subtype of non-small-cell lung cancer (NSCLC).
- Limited studies exist on the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in ASCLC.
- EGFR mutations are potential therapeutic targets in lung cancer.
Purpose of the Study:
- To report a case of ASCLC with an EGFR exon 19 deletion.
- To evaluate the clinical response to gefitinib in a patient with metastatic EGFR-mutated ASCLC.
Main Methods:
- Case report of a 66-year-old female with ASCLC.
- Surgical resection and pathological diagnosis.
- Identification of EGFR exon 19 deletion in both tumor components.
- Treatment with gefitinib following disease progression despite chemotherapy.
Main Results:
- The patient's ASCLC harbored an EGFR exon 19 deletion.
- Gefitinib treatment led to substantial regression of metastatic cavitary lung tumors.
- The patient remained alive and recurrence-free for 19 months post-gefitinib initiation.
Conclusions:
- Gefitinib demonstrated an optimal clinical response in this patient with EGFR mutation-positive ASCLC.
- Gefitinib may be a therapeutic option for a subset of ASCLC patients with specific EGFR mutations.
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