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Cancer Metastases from Lung Adenocarcinoma Disappeared After Molecular Targeted Therapy: A Successfully Clinical
Meng-Jie Li1, Jun Wei2, Guo-Ping Ai3
1Department of Respiratory Oncology, Renmin Hospital of Qingxian, Cangzhou, 062650, People's Republic of China.
Introduction:
Molecular targeted therapy has shown certain therapeutic effects on various cancer types, especially lung cancer. Here, we report a case of a patient with unresectable non-small cell lung cancer (NSCLC) with bone metastases and metastatic lesions that disappeared after molecular targeted therapy.
Patient Information:
A 49-year-old male patient's chest CT scan showed a patchy, slightly high-density shadow on the upper lobe of the left lung with an unclear boundary. The multiple thoracic vertebrae, 4th lumbar vertebrae, multiple ribs, right sacroiliac joint, right hip joint, right inferior ramus of pubis, left middle and upper femur, and right proximal radial bone showed nodular and slightly high-density shadows.
Interventions:
The patient was not considered eligible for tumor resection due to his metastatic lesions. A resected lymph node biopsy was performed. The pathologic findings suggested lung adenocarcinoma, and the gene detection results indicated NM-005228:exon19:c.2235-2249del:p. GLu746-Ala750del (15.31%), NM-005228:exon20:c. G2356A: p. V786M (1.67%). The patient received the icotinib hydrochloride molecular targeted therapy.
Outcomes:
After two months of treatment, pulmonary nodules were basically absent on chest CT scan re-examination. After nine months of treatment, no obvious abnormalities in the thoracic vertebral bone were found on 99mTc-MDP bone scan and CT scan re-examination. No obvious structural abnormalities, such as enlarged lymph nodes, could be found by ultrasound re-examination, and the patient remained alive without recurrence at the five-year follow-up.
Conclusion:
This case report may provide a clue for the future development of molecular targeted therapy for lung cancer. It will allow surgeons to collaborate with oncologists and raise awareness of the benefit of the multidisciplinary approach to the diagnosis and treatment of cancer. Moreover, our results will help patients to fully understand the effect of nonsurgical treatments and improve confidence in the diagnosis and treatment of advanced lung cancer.
Insights
Molecular targeted therapy effectively treated advanced non-small cell lung cancer (NSCLC) with bone metastases. A patient achieved complete remission, remaining cancer-free for five years post-treatment.
Area of Science:
- Oncology
- Molecular Biology
- Radiology
Background:
- Molecular targeted therapy offers promising treatment options for various cancers, including lung cancer.
- Advanced non-small cell lung cancer (NSCLC) with extensive bone metastases presents significant treatment challenges.
Observation:
- A 49-year-old male with unresectable NSCLC and multiple bone metastases was identified.
- Diagnostic imaging revealed lung nodules and metastatic lesions in the thoracic vertebrae, lumbar vertebrae, ribs, and pelvic/femoral bones.
Findings:
- Genetic analysis identified EGFR mutations (exon 19 deletion and V786M).
- The patient received icotinib hydrochloride molecular targeted therapy.
- Remarkable tumor regression was observed, with complete resolution of pulmonary nodules within two months and bone metastases by nine months.
- The patient remained alive and recurrence-free at a five-year follow-up.
Implications:
- This case highlights the efficacy of molecular targeted therapy in managing advanced NSCLC with bone metastases.
- It underscores the importance of genetic profiling for guiding treatment decisions.
- The findings support a multidisciplinary approach and offer hope for patients with advanced lung cancer.
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