Case Presentation: Early-Stage Non-Small Cell Lung Cancer
Patient Case:
This patient is a 62-year-old Asian female with past medical history of hypertension who has presented with ongoing cough. Chest imaging reveals a 6 cm LUL [left upper lobe] mass. She undergoes Bronchoscopy/EBUS [endobronchial ultrasound] and biopsy of LUL mass reveals adenocarcinoma of the lung. Biopsy of mediastinal nodes indicates metastatic carcinoma in stations 4L and 7, while station 4R is negative. A brain MRI and PET scan does not show evidence of metastatic disease.
Her case is presented at the multidisciplinary tumor board, and it is concluded that the patient is not an ideal surgical candidate due to central location of her tumor and proximity to vessels. Molecular profiling of her tumor indicates a PD-L1 TPS of 60% and an EGFR exon 19 deletion mutation. ECOG Performance status is 0.
She is a retired teacher and has 6 pack-year smoking history and quit smoking about 15 years ago. Her physical exam is notable for left sided crackles while the rest of the exam is unremarkable. Her labs including CBC and CMP are within normal limits, except for Hb 11.2 gr/dL. She would like to remain aggressive in her care.
