Neoadjuvant Four-Drug Combination Therapy for NSCLC With EGFR Mutation Avoiding Total Pneumonectomy

Abstract

We report a case of successful neoadjuvant four-drug combination therapy to avoid total pneumonectomy. A 33-year-old male patient was diagnosed with locally advanced non-squamous NSCLC harboring EGFR mutation in the left lower lobe. The patient experienced significant clinical downstaging after two cycles of neoadjuvant therapy, including icotinib, carboplatin, pemetrexed, and bevacizumab. He underwent a successful lobectomy avoiding pneumonectomy. The patient showed no recurrence in the follow-up of a chest computed tomographic scan, which is 17 months after surgery. The promising results of this neoadjuvant combination therapy provided a novel therapeutic option for patients with locally advanced EGFR-mutated NSCLC facing total pneumonectomy.

Erlotinib combined with bevacizumab and chemotherapy in first line osimertinib-resistant NSCLC patient with leptomeningeal metastasis

“…Now, the promising results of various combination therapy are coming out, including TKI plus chemotherapy, [19,20] TKI plus bevacizumab, [10] bevacizumab plus chemotherapy, [21] and eventually TKI plus bevacizumab and chemotherapy [22] . A neoadjuvant 4-agent combination therapy, icotinib plus carboplatin, pemetrexed and bevacizumab, for locally advanced non-squamous NSCLC patient harboring EGFR mutations avoiding total pneumonectomy were reported [23] . Hence, we combined erlotinib, bevacizumab, pemetrexed and cis-platinum 4 drugs to avoid potential resistance.…”

“…[22] A neoadjuvant 4-agent combination therapy, icotinib plus carboplatin, pemetrexed and bevacizumab, for locally advanced non-squamous NSCLC patient harboring EGFR mutations avoiding total pneumonectomy were reported. [23] Hence, we combined erlotinib, bevaci- zumab, pemetrexed and cis-platinum 4 drugs to avoid potential resistance.…”