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Lung Cancer Case Studies

Case Studies: Considerations for Treating Locally Advanced NSCLC

Howard (Jack) West, MD, reviews the case of a 60-year-old woman who presents with, and is treated for, locally advanced non–small cell lung cancer.

Considerations for Treating Locally Advanced NSCLC

A 60-year-old Asian Woman With Unresectable, Locally Advanced NSCLC

  • A 60-year-old Asian woman presents with complaints of chest pain and shortness of breath. She reports developing a persistent cough about 1 year ago, which she attributed to allergies. In the past month, she has “spit up” blood several times, which caused her to make the appointment.
  • Her history includes:
    • Former smoker, quit smoking at age 35 when she became pregnant
    • Normal BMI, postmenopausal, no history of cardiovascular disease
    • No previous cancer history
  • Evaluation and follow up testing reveal
    • Stage IIIA NSCLC in right bronchi: 3.5-cm tumor with pleural involvement and spread to mediastinal lymph nodes
    • WHO performance status 1
    • Histology: Squamous cell
    • Biomarkers:
      • EGFR, BRAF, ALK/ROS1 negative
      • PD-L1 status: 10%
  • After multidisciplinary evaluation, the patient was determined not to be a candidate for surgery, and completed chemoradiotherapy:
    • Carboplatin/paclitaxel doublet plus 55 Gy radiotherapy
    • Achieved stable disease without progression 14 days after completing treatment
    • Began treatment with durvalumab
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