CASE SELECTION 1: Long-Term Survival with EGFR-TKI-Resistence in Stage 4 NSCLC
“Case Selection” is a new format designed to highlight inspiring patient cases focused on challenging situations such as multiple recurrences, rare subtypes, no longer response to standard treatments. Each case is derived exclusively from peer-reviewed medical journal case reports, rewritten by Patient Savvy in clear, easy-to-understand language without altering any critical information.
In this first collection, we discuss EGFR-TKI-resistant in stage 4 NSCLC. Despite negative prognosis statistics, many patients have achieved long-term survival by undergoing multiple lines of treatment—an option not always explicitly detailed in standard treatment guidelines (You can download FREE HERE). This underscores the importance of self-advocacy and proactive discussions with your doctor to push for personalized treatment plans.
Eric’s 6-year story
Stage IV NSCLC adenocarcinoma with multiple recurrences
Erlotinib, osimertinib, dabrafenib, trametinib, etc.
Eric, a 67-year-old non-smoker, began experiencing severe back pain, leading to a diagnosis of advanced lung cancer. Doctors found stage IV lung adenocarcinoma that had spread to bones, liver, lymph nodes, and brain. Tests revealed an EGFR exon 19 deletion mutation.
Eric initially responded well to the targeted drug erlotinib for over two years. However, after 26 months, he experienced vision problems due to new metastases in his eyes. Genetic testing identified an additional mutation (EGFR T790M), prompting treatment with osimertinib, which controlled his cancer effectively for three years.
Eventually, Eric’s cancer progressed again, this time with BRAF V600E mutation identified. Chemotherapy with carboplatin and pemetrexed initially worked, but after 6 months, cancer spread to the lining of his brain, causing serious neurological symptoms.
Eric then received a combination therapy of osimertinib, dabrafenib, and trametinib. Within three months, he experienced a remarkable improvement, fully recovering neurologically. Despite side effects including fever, low platelet counts, and mild lung inflammation, treatment adjustments enabled continued therapy. Over a year later, Eric remains stable and continues managing his cancer effectively.
Source: Valet, O., et al. JTO Clinical and Research Reports, 2(6), 100192.
Yumi’s 24-year story
Three recurrences, progressed from stage IB to IV
Surgery, chemotherapies, radiation and (re-challenged) gefitinib
Yumi, a healthy 58-year-old woman from Japan who never smoked, began her cancer journey unexpectedly in 1999. A routine screening found a tumor in her right lung, diagnosed as stage IB lung cancer (adenocarcinoma). She underwent surgery and chemotherapy with UFT, initially responding well.
However, cancer returned in 2002 in her upper right lung. She received docetaxel, followed by gefitinib, a targeted therapy. Treatment with gefitinib was challenging due to skin side effects and paused frequently. Cancer spread to nearby lymph nodes, requiring radiation therapy.
After 4 stable years, multiple tumors appeared in both lungs. Chemotherapy with carboplatin and pemetrexed successfully shrank these tumors. Doctors later discovered her cancer had an EGFR L858R mutation, highly responsive to gefitinib.
Restarting gefitinib therapy led to excellent results, and Yumi has effectively managed her cancer for over 13 years with minimal side effects. Recent blood tests couldn’t detect the mutation, possibly due to test limitations, but Yumi remains stable, and gefitinib treatment continues.
Source: Hayashi, et al., 2024, Journal of Immunotherapy and Precision Oncology
Li’s 12-year story
Multiple recurrences, progressed from stage III to IV
Mrs. Li, a 48 y/o woman, was diagnosed with stage IIIB adenocarcinoma of the left lung in July 2009, with cancer spreading to nearby lymph nodes. Initially, she received chemotherapy with gemcitabine and cisplatin but chose to switch to targeted therapy due to personal preference.
Although genetic tests didn’t initially show mutations responsive to EGFR inhibitors, doctors selected gefitinib based on her profile as a non-smoker with adenocarcinoma, traits typically responsive to this therapy. Gefitinib started in January 2010, successfully shrinking her tumors without significant side effects. By July 2015, however, the cancer spread to her brain, which was treated effectively with radiation therapy.
Doctors then switched her to osimertinib, though tests again found no responsive mutations.
Despite various treatments, Mrs. Li’s cancer progressed. Chemotherapy with pemetrexed and oxaliplatin plus hyperthermia therapy in 2020 did not halt tumor growth.
Immunotherapy with toripalimab and anlotinib also proved ineffective. In April 2021, she returned to EGFR inhibitor treatment with an increased dose of icotinib, shrinking her lung metastases.
Sadly, after bravely fighting cancer for 12 years, Mrs. Li was hospitalized in June 2021 and passed away due to complications from a stroke.
Source: HChinese Medical Information Network, 2022
We deliver real-life, evidence-based stories of cancer patients who’ve achieved positive outcomes—closely matched to your condition
