MDT management of an advanced NSCLC patient with EGFR mutation

We report a patient with advanced non-small-cell lung cancer (NSCLC) and epidermal growth factor receptor (EGFR) mutation, who showed different responses to EGFR-tyrosine kinase inhibitors (TKIs) and subsequently benefited from multidisciplinary team (MDT) management. The patient was diagnosed with stage IV adenocarcinoma of the left lung by CT guided lung puncture, with metastasis in the lung hilus, mediastina, bilateral lung and brain. Genetic screening detected a deletion in exon 19 of EGFR. The patient received EGFR-TKIs as the first line therapy. After treatment, the left lung lesion showed persistent response, but the lesion in the right lung was progressively enlarged. A second biopsy from the right lung lesion revealed squamous cell carcinoma. The patient then received chemotherapy and regional radiation for the lesion in the right lung. All of the lesions were well controlled afterwards. With several MDT discussions, an individualized therapy was implemented and the survival was prolonged.