| Description |
In this study, a Chinese female patient was diagnosed with EGFR19 exon deletion lung adenocarcinoma on January 6, 2014, and showed a positive response to chemotherapy combined with MWA and TKI drugs despite multiple oligoprogression. Firstly, the patient received 4 cycles of chemotherapy (120 mg docetaxel on day 1, 40 mg cisplatin on days 1 and 2; q21) and gefitinib (Iressa; 250 mg/day), maintaining partial remission for 16 months. On August 24, 2015, a new solitary lesion was found in the right lung, and erlotinib (Truvada; 150 mg/day) was switched for 3 months, and the new right lung lesion and the primary left lung lesion were ablated on January 19 and 26, 2016, respectively. Subsequently, 6 cycles of chemotherapy (0.8 g pemetrexed on day 1, 70 mg on days 1 and 2; q21) were performed, with stable efficacy evaluation. On May 7, 2016, the patient began to use osimertinib (AZD9291; 80 mg/day) treatment, and the mediastinal lymph nodes were rapidly shrunk one month later, and the patient has sustained a benefit for 82 months. It is worth noting that the patient also had metachronous colon cancer on January 13, 2020, followed by right posterior liver metastasis on February 28, 2020, and lung metastasis on May 5, 2021 and February 2022. To address this issue, the patient underwent radical resection of colon cancer, liver metastasectomy, and received bevacizumab combined with chemotherapy and MWA for lung metastases. The patient has achieved a long-term survival of 110 months. In summary, this case highlighted the potential of MWA combined with systemic therapy in the treatment of patients with advanced lung adenocarcinoma with EGFR exon 19 deletion and metachronous lung and liver metastases from colon adenocarcinoma. MWA can effectively control in situ progression and new oligometastases, thereby improving the efficacy of systemic chemotherapy/TKI therapy. In addition, this case report emphasizes the importance of repeated histological biopsies and genetic testing as reliable indicators for adjusting treatment regimens. Physicians should also be vigilant for the occurrence of secondary primary cancer. Timely and accurate adjustment of treatment regimens will bring significant benefits to patients in terms of treatment efficacy and overall quality of life. |
