Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2018; 6(7): 150-155
Published online Jul 16, 2018. doi: 10.12998/wjcc.v6.i7.150
Achievable complete remission of advanced non-small-cell lung cancer: Case report and review of the literature
Ning-Ning Yang, Fei Xiong, Qing He, Yong-Song Guan
Ning-Ning Yang, Fei Xiong, Qing He, Yong-Song Guan, Department of Oncology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Yang NN, Xiong F and He Q performed the operation and collected clinical data; Guan YS helped to design, write and revise the paper.
Informed consent statement: Witten informed consent was obtained from the patient and his family before all procedures described in the report as well as for the use of the patient’s clinical information and images for publication.
Conflict-of-interest statement: All the authors declare that there is no conflict of interest related to this report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yong-Song Guan, MD, PhD, Professor, Department of Oncology, West China Hospital of Sichuan University, 37 Guoxuexiang Street, Chengdu 610041, Sichuan Province, China. yongsongguan@yahoo.com
Telephone: +86-28-85423278 Fax: +86-28-85423278
Received: February 22, 2018
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
ARTICLE HIGHLIGHTS
Case characteristics

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.

Clinical diagnosis

The patient was admitted to our institution with a 2-mo history of cough.

Differential diagnosis

The differential diagnosis included pulmonary tuberculosis, lobular pneunonia, or benign lung tumors.

Laboratory diagnosis

Blood test was normal. Genetic testing revealed that epidermal growth factor receptor (EGFR) mutation was found with the L858R substitution in exon 21.

Imaging diagnosis

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.

Pathological diagnosis

Examination of the pathologic specimen after percutaneous lung biopsy, confirmed a moderate differentiated adenocarcinoma.

Treatment

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.

Related reports

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.

Term explanation

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.

Experiences and lessons

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.