Kim Chanmi, Park Jongsoo, Lee Jang Hoon, Jeong Seong Yong, Ahn June Hong
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Pulmonology and Allergy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Transl Lung Cancer Res. 2025 Feb 28;14(2):614-618. doi: 10.21037/tlcr-24-893. Epub 2025 Feb 27.
Salvage surgery following epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor therapy is a viable treatment option for selected patients with initially unresectable non-small cell lung cancer (NSCLC) harboring mutations.
We herein describe a 63-year-old man who presented to the emergency department with a 1-week history of speech disturbance and was diagnosed with clinical stage T1cN2M1b, IVA NSCLC with an exon 21 L858R mutation. The patient underwent brain tumor resection followed by stereotactic radiosurgery and was treated with palliative lazertinib for 6 months. A radiologic complete response was observed in follow-up imaging, and salvage surgery was recommended after multidisciplinary consultation. Right upper lobectomy with mediastinal lymph node dissection revealed a pathologic complete response with no residual tumor cells. The patient remained disease-free for 1 year following lazertinib treatment.
This case suggests that salvage surgery after treatment with lazertinib may be a safe and effective approach for NSCLC with common mutations.
对于部分初始不可切除且携带表皮生长因子受体（EGFR）酪氨酸激酶抑制剂治疗后可挽救性手术是一种可行的治疗选择。
我们在此描述一名63岁男性，因言语障碍1周就诊于急诊科，被诊断为临床分期T1cN2M1b，IVA期非小细胞肺癌伴外显子21 L858R突变。患者接受了脑肿瘤切除术，随后进行立体定向放射外科治疗，并接受姑息性来泽替尼治疗6个月。随访影像学检查观察到放射学完全缓解，多学科会诊后建议进行挽救性手术。右上叶切除加纵隔淋巴结清扫显示病理完全缓解，无残留肿瘤细胞。来泽替尼治疗后患者无病生存1年。
该病例提示，来泽替尼治疗后进行挽救性手术可能是治疗常见突变型非小细胞肺癌的一种安全有效的方法。
