Prolonged survival with maintenance pemetrexed for a multiple primary malignancy

Despite the fact that multiple primary malignancies (MPMs) are not new and have been diagnosed for about a hundred-year time, literatures on lung and colon primaries are scarce. We report a case of a 62-year-old Asian Bangladeshi man with stage IV lung adenocarcinoma who developed a metachronous stage II colon adenocarcinoma approximately 3 years later. A chemotherapy protocol of six cycles of pemetrexed/cisplatin followed by maintenance pemetrexed was used, and surgery was done for the colon primary. With more than 5 years of periodic follow-up, his disease remains stable without any local or metastatic recurrence. Definitive therapeutic protocols are unavailable, but information taken with caution from case reports may be of importance for treatment decisions of MPMs. We believe that management with careful judgement by a multidisciplinary team may result in a good outcome with longer survival.