Long-term Survival in a Patient with Advanced Non-smoking Lung Adenocarcinoma and No EGFR Mutation After Comprehensive Therapy with EGFR-TKI-based Therapy: A Case Report

Rationale: This is the first known report to describe a case of advanced non-smoking lung adenocarcinoma with no epidermal growth factor receptor mutation after comprehensive epidermal growth factor receptor-tyrosine kinase inhibitor-based therapy that survived for nearly 12 years.

Patient Concerns: A 48-year-old Chinese woman that came to our hospital with a left supraclavicular mass.

Diagnosis: The final diagnosis was left lung adenocarcinoma with left supraclavicular lymph node metastasis, cT1N3M0 IIIB (International association for the Study of lung cancer 6th version).

Interventions: After 4 months of 4 cycles of chemotherapy, gefitinib was administered alone for 5.5 years. Local radiotherapy (40GY/20F) was administered for 1 month, and osimertinib alone was followed for 4.5 years. A combination of pemetrexed with oxaliplatin and hyperthermia at the same time was administered for 4 cycles. Toripalimab and anlotinib were administered for 3 months. Since then, the patient had been taking a double dose of icotinib herself.

Outcomes: The patient has survived for nearly 12 years since diagnosis of lung cancer.

Lessons: Our case is of significant importance to clinicians involved in the treatment of patients with advanced nonsmoking lung adenocarcinoma and no epidermal growth factor receptor mutations.