Kolkata: A septuagenarian whose Stage IV lung cancer had spread extensively to her bones, causing fractures in both upper arms, has regained an independent life and achieved PET CT confirmed-completed metabolic response following third generation targeted therapy at HCG Cancer Hospital, Kolkata.
The case, highlighted around World Lung Cancer Day observed on August 1, underscores the role of molecular testing in identifying mutation-guided treatment options even when cancer has spread extensively.
Cancer was a chance discovery after she suffered pathological fractures caused by weakened bones. PET-CT scans had revealed a relatively small tumour in the right lung but extensive metastases involving the skull, spine, ribs, pelvis and limbs. The fractures were surgically stabilised, and a biopsy confirmed metastatic lung adenocarcinoma.
Next-generation sequencing detected an EGFR mutation, enabling doctors to start oral targeted therapy with dacomitinib. The patient responded well initially but about 18 months later, scans showed renewed activity in the bones. Following a multidisciplinary tumour-board review, treatment was changed to the third-generation targeted drug osimertinib. The patient subsequently developed neurological weakness, with nerve-conduction studies showing axonal neuropathy. She recovered gradually with neuro-supportive care and intravenous immunoglobulin therapy. Her latest PET-CT showed a complete metabolic response, and she can now walk, cook and perform her daily activities independently.
“Molecular testing identified a treatable mutation and allowed us to select targeted oral therapy. When the disease progressed, treatment was adapted through a tumour-board decision. Despite extensive bone metastases and a neurological setback, the patient has regained her independence,” said Dr Sanchayan Mandal, Senior Consultant, Medical Oncology, HCG Cancer Hospital, Kolkata.
According to GLOBOCAN estimates, India recorded approximately 1.13 lakh new lung-cancer cases and nearly 99,000 related deaths, making it the leading cause of cancer related mortality.
“Advanced cancer care must be prepared to meet new challenges at every stage. This case shows how coordinated teams can adapt treatment when the disease progresses, manage complications and help the patient regain independence,” said Dr Rupali Basu, RBH, HCG Cancer Hospitals.
