Lung cancer : journal of the International Association for the Study of Lung Cancer
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Case Reports
Synchronous primary lung adenocarcinomas harboring distinct MET Exon 14 splice site mutations.
When a patient is found to have multiple lung tumors, distinguishing whether they represent metastatic nodules or separate primary cancers is crucial for staging and therapy. We report the case of a 79-year-old patient with two surgically resected synchronous left upper lobe adenocarcinomas initially pathologically staged as T3 (IIB), indicating adjuvant chemotherapy should be recommended. However, the tumors appeared radiographically distinct, so next-generation sequencing was performed on each nodule. ⋯ Thus, the patient was down-staged to having two separate IA tumors, spared of adjuvant chemotherapy, and routine surveillance was recommended. This case highlights the utility of using molecular analysis in diagnosing and treating multifocal lung tumors, and the process of convergent molecular evolution toward a common oncogenic driver mutation. This is the first case of multiple synchronous lung tumors each harboring a distinct MET exon 14 splice site mutation.
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A role for erlotinib and bevacizumab as single agents has been established in the treatment of non-small cell lung cancer (NSCLC). However, the efficacy and safety of erlotinib in combination with bevacizumab compared with single agents remain unclear. This meta-analysis aimed to investigate the status of this combined strategy in NSCLC. ⋯ Erlotinib plus bevacizumab enhances OS for EGFR-mutant patients, with rash and diarrhea common but acceptable adverse effects. Combination treatment can be recommended as the preferable option for EGFR-mutant patients. Further large-scale, well-designed RCTs are required to confirm our validation.
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Multicenter Study
Nivolumab in advanced non-small-cell lung cancer patients who failed prior platinum-based chemotherapy.
To investigate the efficacy and safety of nivolumab in Korean patients with stage IIIB/IV or recurrent non-small-cell lung cancer (NSCLC) who failed platinum-based chemotherapy. ⋯ The efficacy and safety of nivolumab in Korean patients with advanced or recurrent squamous or non-squamous NSCLC are consistent with previous reports.