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A. Okada

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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-032 - Surgical Resection for Lung Adenocarcinoma after Afatinib Treatment (ID 2298)

      09:30 - 17:00  |  Author(s): A. Okada

      • Abstract
      • Slides

      Afatinib, an irreversible ErbB family blocker, has shown superiority to chemotherapy in patients with epidermal growth factor receptor gene (EGFR) mutated non-small cell lung cancer. However, there has been no report about the preoperative Afatinib treatment. We report a case of surgical resection for lung adenocarcinoma after Afatinib treatment.

      A 33-year-old female with a chronic cough was referred to our hospital because of an abnormality on a chest radiograph. Computed Tomography (CT) displayed consolidation in left lower lobe. On bronchoscopic examination, her disease was diagnosed as adenocarcinoma of the lung, harboring EGFR mutation (exson19 deletions). Contrast-enhanced brain magnetic resonance imaging showed 4 brain metastases. Positron emission topography (PET) revealed abnormal accumulation in left lower lobe, lymph nodes (station 1, 4R, 5) and plevis. Her clinical staging was IV (T4N3M1b). Stereotactic radiotherapy for brain metastases (total 35Gy:7Gy/fraction) was done, and Afatinib was administered for 6 months.

      These treatments resulted in a down-stage (T1aN0M1b) ; CT showed that the consolidation shrank and a single nodule (20mm) remained in S8 of left lower lobe. 3 of the brain metastases lost and the rest one diminished. PET revealed slight FDG uptake only in the nodule in S8 but not regional lymph node or in a distant site. We performed surgical resection for the nodule. Pathological examination revealed no cancer rest. The postoperative course was uneventful. She has been continuing Afatinib for 3 months without any recurrence after the surgery.

      We report the first case, to our knowledge, of a patient who obtained significant response to Afatinib and was proved no cancer rest by surgical resection. Although more observation period for this patient and prospective study are needed, this report provides insight into the efficacy of surgical resection after Afatinib treatment.

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