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Is distinct EGFR mutation status proof of second simultaneous primary non-small cell lung cancer?

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Abstract

We present the case of a 54-year-old woman diagnosed with two simultaneous adenocarcinomas in the right and left upper lobe of the lungs. The patient was treated with two curative intended resections and chemotherapy. The molecular analysis showed distinct EGFR mutation pattern in both adenocarcinomas of the lung. During the clinical course, the adenocarcinoma without EGFR mutation relapsed multiple times in the right lung resulting finally in pneumonectomy in 2009. Since then, the patient had no indication of relapse. The case demonstrates the difficulty to clinically discriminate a palliative metastatic situation from a potential curable situation with two simultaneous primary adenocarcinomas of the lung. We propose that a different molecular pattern between lesions could be used as an argument for the presence of two simultaneous primary tumors. In the case of distinct EGFR mutation pattern, therapy could be performed with curative intent.

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References

  1. Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/American thoracic society/European respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6:244–85.

    Article  PubMed  Google Scholar 

  2. Zappa F, Betticher DC, von Moos R, Brutsche MH, Baty F, Bubendorf L, et al. Bevacizumab (B) and erlotinib (E) as first-line therapy in metastatic nonsquamous non-small cell lung cancer (NSCLC) followed by platinum-based chemotherapy (CT) at disease progression (PD): a multicenter phase II trial, SAKK 19/05. J Clin Oncol. 2011;29 (Suppl abstr 7561).

  3. Lynch TJ, Bell DW, Sordella R, et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med. 2004;350:2129–39.

    Article  CAS  PubMed  Google Scholar 

  4. Pao W, Miller V, Zakowski M, et al. EGF receptor gene mutations are common in lung cancers from “never smokers” and are associated with sensitivity of tumors to gefitinib and erlotinib. Proc Natl Acad Sci USA. 2004;101:13306–11.

    Article  CAS  PubMed  Google Scholar 

  5. Paez JG, Janne PA, Lee JC, et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004;304:1497–1500.

    Article  CAS  PubMed  Google Scholar 

  6. Finberg KE, Sequist LV, Joshi VA, et al. Mucinous differentiation correlates with absence of EGFR mutation and presence of KRAS mutation in lung adenocarcinomas with bronchioloalveolar features. J Mol Diagn. 2007;9:320–6.

    Article  CAS  PubMed  Google Scholar 

  7. Yoshizawa A, Motoi N, Riely GJ, et al. Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol. 2011;24:653–64.

    Article  CAS  PubMed  Google Scholar 

  8. Schmidt-Kittler O, Ragg T, Daskalakis A, et al. From latent disseminated cells to overt metastasis: genetic analysis of systemic breast cancer progression. Proc Natl Acad Sci USA. 2003;100:7737–42.

    Article  CAS  PubMed  Google Scholar 

  9. Weichert W, Schewe C, Denkert C, et al. Molecular HPV typing as a diagnostic tool to discriminate primary from metastatic squamous cell carcinoma of the lung. Am J Surg Pathol. 2009;33:513–20.

    Article  PubMed  Google Scholar 

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The authors declare that there is no actual or potential conflict of interest in relation to this article.

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Correspondence to Ulf Petrausch.

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Petrausch, U., Tischler, V., Weder, W. et al. Is distinct EGFR mutation status proof of second simultaneous primary non-small cell lung cancer?. memo 5, 154–156 (2012). https://doi.org/10.1007/s12254-012-0026-z

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  • DOI: https://doi.org/10.1007/s12254-012-0026-z

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