Published online Jul 16, 2018. doi: 10.12998/wjcc.v6.i7.150
Peer-review started: February 22, 2018
First decision: March 12, 2018
Revised: March 15, 2018
Accepted: April 22, 2018
Article in press: April 22, 2018
Published online: July 16, 2018
Processing time: 144 Days and 12 Hours
A 73-year-old man who was diagnosed with advanced non-small-cell lung cancer (NSCLC), received the combination therapy of bronchial artery infusion chemotherapy and oral icotinib hydrochloride, and the objective response was evaluated to be approximately complete regression.
The patient was admitted to our institution with a 2-mo history of cough.
The differential diagnosis included pulmonary tuberculosis, lobular pneunonia, or benign lung tumors.
Blood test was normal. Genetic testing revealed that epidermal growth factor receptor (EGFR) mutation was found with the L858R substitution in exon 21.
Transverse computed tomography scan showed the tumor mass in the basal segment of the left lower lobe and the greatest dimension of the tumor measured 5.7 cm.
Examination of the pathologic specimen after percutaneous lung biopsy, confirmed a moderate differentiated adenocarcinoma.
The patient received left bronchial artery chemical infusion (60 mg cisplatin, 40 mg hydroxycamptothecine, and 1000 mg 5-fluorouracil, respectively) and oral icotinib hydrochloride (125 mg, every eight hours) was initiated on postoperative day 4.
Other studies on EGFR-TKI therapy in combination with arterial infusion chemotherapy reported that the median OS was 28.6 mo, and in our case, the patient received the treatment for more than 48 mo without apparent adverse effects.
Bronchial artery chemical infusion employs direct injection of chemotherapeutics at high concentrations into local lesions of lung cancer, with the potential to reduce the tumor size and to relieve symptoms, with low toxicity and good repeatability.
This case report suggests that the combination of oral icotinib hydrochloride and BAI chemotherapy is safe, well-tolerated and effective in Chinese patients suffering from advanced NSCLC with EGFR gene mutations.