Stage I Lung Adenocarcinoma With Later Kidney Metastases Responding to Osimertinib

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Adenocarcinoma
Biomarkers
EGFR L858R mutation; RB1 mutation; MAP3K1 mutation; PD-L1 negative
Sex
female
Spread to
kidneys, peritoneal lymph nodes
Treatment
surgery and targeted therapy
Outcome
Responding Well

Treatment course, step by step

  1. Underwent right upper lobectomy with lymph-node dissection in May 2021 and received no adjuvant treatment.
  2. Started osimertinib after biopsy-confirmed kidney metastases were found in April 2023.
  3. Continued osimertinib after a partial response.

What happened, in summary

A 59-year-old woman had a right upper-lung nodule found during a health examination in May 2021. Surgery the next day removed the right upper lobe and nearby lymph nodes. Pathology confirmed Stage I invasive lung adenocarcinoma with clear margins and no involved lymph nodes. She did not need postoperative treatment and entered regular surveillance.

In April 2023, PET-CT found several masses in both kidneys as well as metastatic lymph nodes in the peritoneal area. Biopsy of the largest kidney mass showed markers matching lung adenocarcinoma rather than a new kidney cancer, confirming metastatic recurrence and Stage IV disease.

Genetic testing of both the original lung tumor and the kidney metastasis found an EGFR L858R mutation along with RB1 and MAP3K1 alterations. PD-L1 testing was negative.

She started osimertinib. After 6 weeks, follow-up CT showed a partial response. She continued osimertinib and was alive at the latest documented follow-up.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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