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Lung Cancer Case Studies

Case Studies: Frontline Treatment Strategies in EGFR-Mutant NSCLC

Heather Wakelee, MD, reviews the case of a 73-year-old Caucasian man who presents with EGFR-mutant non–small cell lung cancer and is treated with osimertinib, a third-generation EGFR tyrosine kinase inhibitor.

Frontline Treatment Strategies in EGFR-Mutant NSCLC

December 2017

  • A 73-year-old Caucasian man was seen in the emergency department for severe dyspnea and chest pain
  • History: symptomatic COPD managed on fluticasone and vilanterol inhaler; 50-pack/year smoking history
  • Imaging studies:
    • Chest X-Ray showed a large mass in the lung right upper lobe
    • CT of chest, abdomen, and pelvis revealed a 6.8-cm mass right-sided mass invading the chest wall, small left pleural effusion, and several small lytic lesions in the T4/5 vertebrae
  • CT-guided transthoracic needle biopsy of the lung lesion showed grade 2 adenocarcinoma
  • Molecular testing, NGS: EGFR exon 21 L858R mutation
  • Staging: T3N0M1
  • ECOG 1
  • The patient was started on osimertinib 80 mg once daily
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