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A case report of metastatic lung adenocarcinoma with long-term survival for over 11 years
Tatsu Matsuzaki1, Eri Iwami, Kotaro Sasahara
1Department of Respiratory Medicine, Tokyo Dental College, Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba, Japan.
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.
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