Oligometastatic EGFR-Mutated NSCLC - Is There a Role for Surgical Treatment-Oligometastatic EGFR-Mutated NSCLC

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The document details the case of a 55-year-old female with EGFR-mutated non-small cell lung cancer (NSCLC), diagnosed during the COVID-19 pandemic after a CT scan revealed a lung lesion. Subsequent PET-CT and biopsy confirmed adenocarcinoma with right paratracheal lymph node involvement and brain metastases. Initial treatments included antibiotics, given her fear of illness during the pandemic, but further diagnosis necessitated a more targeted approach.<br /><br />The patient, never a smoker but with a familial history of cancer, underwent comprehensive testing, including EBUS mediastinal staging and molecular profiling, which confirmed EGFR mutation (exon 19 deletion). The treatment plan involved initiating osimertinib, a targeted therapy, due to the stage IVB diagnosis with brain metastases. The Tumor Board decided against immediate radiotherapy or surgery since the patient was neurologically asymptomatic with small CNS lesions.<br /><br />Remarkably, the patient exhibited an excellent response to osimertinib, significantly reducing the lung mass size and showing no signs of brain disease. A multidisciplinary team concluded that surgical resection would be beneficial, scheduling a right upper lobectomy and lymphadenectomy.<br /><br />Post-surgery, follow-up PET-CT indicated further reduction in lesion size and no disease evidence. The patient recovered well, maintained osimertinib treatment, and remained asymptomatic, leading to the conclusion that she is currently in follow-up with no evident disease.<br /><br />The case underscores the significance of appropriate EGFR-mutated NSCLC staging, exploring surgical options, and ensuring a multidisciplinary approach for tailored patient care. This comprehensive and patient-centered treatment approach exemplifies effective management of oligometastatic NSCLC.

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Amazing Case Race - Case Study

Keywords

EGFR-mutated

non-small cell lung cancer

NSCLC

osimertinib

brain metastases

adenocarcinoma

molecular profiling

multidisciplinary approach

oligometastatic

targeted therapy