A 63-Year-Old Woman With Metastatic EGFR-Mutated Non-Small Cell Lung Cancer
A 63-Year-Old Woman With Metastatic EGFR-Mutated Non-Small Cell Lung Cancer
Case: A 63-Year-Old Woman With MetastaticEGFR+ NSCLC
Initial presentation
- A 63-year-old woman presented with persistent cough, and a 5-lb weight loss
- PMH/SH: former smoker, quit 25 years ago
- PE: Decreased breath sounds on auscultation in the right lower lobe
Clinical workup
- Labs: WNL
- PFT: FEV1/FVC 60%; DLCO 68%
- Chest X-ray showed a right lower lobe soft tissue mass
- Chest/abdominal/pelvic CT showed a 3.8-cm solid pulmonary mass in the right lower lobe; enlarged contralateral hilar and mediastinal lymph nodes; 3 small right adrenal lesions noted
- CT‐guided core needle biopsy of the lung mass revealed lung adenocarcinoma; lymph node biopsy showed grade 2 adenocarcinoma
- Contrast‐enhanced MRI of the head showed no evidence of brain metastases
- Molecular testing:EGFRexon 21 substitution L858R, ALK-, BRAF-, ROS1-, RET-, MET-, ERBB2-,PD-L1 TPS 14%
- Staging- T2aN3M1b - IVA; ECOG PS 0
Treatment
- Patient was started on erlotinib 150 mg PO qDay + ramucirumab 10 mg/kg IV
- Imaging at 3-month showed partial response with decrease in lung lesion
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