Erlotinib-induced complete response in a patient with epidermal growth factor receptor wild-type lung adenocarcinoma after chemotherapy failure: a case report.

Carmela Barbato,Roberto Monaco,Paola Galloro,Carmela Mocerino,Giacomo Cartenì,Maria Giuseppa Vitale,Ferdinando Riccardi,Nicola Gagliardi

doi:10.1186/1752-1947-8-102

Abstract

IntroductionThe efficacy of erlotinib in advanced non-small-cell lung cancer has been demonstrated in several trials, but only two cases of complete and prolonged response in wild-type epidermal growth factor receptor locally advanced lung cancer have been published.Case presentationWe discuss a case of a 67-year-old Caucasian man, a former heavy cigarette smoker, with a diagnosis of wild-type epidermal growth factor receptor locally advanced adenocarcinoma. After platinum-based doublet chemotherapy, when a progression of disease had occurred, a second-line therapy with erlotinib was started. We observed a progressive reduction of his lung lesion during erlotinib treatment until there was a complete clinical response.ConclusionsThis case is interesting for the choice of second-line treatment in non-small-cell lung cancer and, moreover, for the possibility of a complete and prolonged response to erlotinib even in patients without the activating mutation of epidermal growth factor receptor.

Highlights

The efficacy of erlotinib in advanced non-small-cell lung cancer has been demonstrated in several trials, but only two cases of complete and prolonged response in wild-type epidermal growth factor receptor locally advanced lung cancer have been published.Case presentation: We discuss a case of a 67-year-old Caucasian man, a former heavy cigarette smoker, with a diagnosis of wild-type epidermal growth factor receptor locally advanced adenocarcinoma
This case is interesting for the choice of second-line treatment in non-small-cell lung cancer and, for the possibility of a complete and prolonged response to erlotinib even in patients without the activating mutation of epidermal growth factor receptor
To the best of our knowledge, there are only two cases described in the literature of a complete response to second-line therapy with erlotinib in epidermal growth factor receptor (EGFR) wild-type nonsmall-cell lung cancer (NSCLC) [21,22]

Summary

Conclusions

To the best of our knowledge, there are only two cases described in the literature of a complete response to second-line therapy with erlotinib in EGFR wild-type NSCLC [21,22]. In the present case report, the choice of erlotinib in second line of treatment exhibited a surprising response, because the clinical characteristics of our patient did not correlate with those predictive of response or benefit. In the BR. trial the OS and the PFS have been 6.7 and 2.2 months, respectively, in the erlotinib-treated subset, our patient has already exceeded those periods of time gaining a survival benefit From this we suggest that no assumptions should be made on the EGFR test in the choice of second-line treatment for advanced NSCLC. Author details 1UOSC Oncologia, Azienda Ospedaliera di Rilievo Nazionale “Antonio Cardarelli”, Naples, Italy. Author details 1UOSC Oncologia, Azienda Ospedaliera di Rilievo Nazionale “Antonio Cardarelli”, Naples, Italy. 2UOSC Anatomia Patologica, Azienda Ospedaliera di Rilievo Nazionale “Antonio Cardarelli”, Naples, Italy. 3UOSC Radiologia, Azienda Ospedaliera di Rilievo Nazionale “Antonio Cardarelli”, Naples, Italy

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