ONCAlert | Upfront Therapy for mRCC
Lung Cancer Case Studies

Case Studies: Clinical Decisions in Non-Driver NSCLC

Benjamin P. Levy, MD, describes the case of a 55-year-old woman who is diagnosed with non-driver non–small cell lung cancer.

Clinical Decisions in Non-Driver NSCLC

  • A 55-year old female presented with chronic cough and 10-lb weight loss
  • PMH: never smoker; no family history of cancer; no known exposure to chemicals or asbestos
  • Chest x-ray showed a 5.0-cm lesion in the left lower lobe with bulky lymphadenopathy
  • Chest CT scan confirmed the presence of a lung mass and enlargement of the right hilar lymph node and bilateral mediastinal lymph nodes
  • EUS-guided biopsy was performed
  • Pathology revealed adenocarcinoma
  • Molecular testing:
    • FISH: negative for ALK translocation
    • NGS: negative for EGFR, ROS1, RET, BRAF, KRAS
    • IHC: PD-L1 expression in 0% of cells
  • PET/CT imaging showed 18F-FDG uptake in the lung mass, right hilar lymph node, mediastinum, and left adrenal gland
  • MRI of the brain was normal
  • ECOG PS, 0
  • The patient was started on therapy with carboplatin/pemetrexed and bevacizumab
  • The regimen was well tolerated
  • After 6 cycles, the patient had a good response
  • She was continued on bevacizumab
  • After 9 months on therapy, the patient developed cough and weight loss
  • Follow-up imaging revealed multiple new lesions in the left adrenal gland and new liver metastases
  • Patient was started on atezolizumab, planned for 12 months
Publications
Copyright © TargetedOnc 2019 Intellisphere, LLC. All Rights Reserved.