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Lung Cancer Case Studies

Case Studies: Treatment of EGFR Mutant Non-Small Cell Lung Cancer

In this case-based interview, Roy Herbst, MD, PhD, discusses the treatment of a patient who develops EGFR mutant non-small cell lung cancer.

Treatment of EGFR Mutant Non-Small Cell Lung Cancer

  • 65-year-old male, former smoker (25 pack-years, quit 12 years ago) presented complaining of persistent lower back pain, extreme fatigue, shortness of breath, and a 25-lb weight loss in the past 6 months.
  • PMH includes rheumatoid arthritis which significantly limits his physical activity.
  • Back pain also limited the patient’s daily activity.
  • MRI of the spine showed evidence of multiple lesions, but none were causing cord compression.
  • CT of the chest showed a 4-cm mass in the left lung, with enlarged bilateral mediastinal lymph nodes.
  • The MRI of the brain revealed no metastases.
  • ECOG PS was assessed to be 2. 
  • He underwent an endobronchial ultrasound-directed biopsy of the mediastinal lymph nodes.
  • Pathology revealed poorly differentiated adenocarcinoma.
  • Molecular testing showed a mutation in EGFR exon19 deletion.
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