Pathologic complete response following salvage surgery after lazertinib treatment in advanced EGFR-mutated lung adenocarcinoma: case report and literature review

Abstract

Background: Salvage surgery following epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor therapy is a viable treatment option for selected patients with initially unresectable non-small cell lung cancer (NSCLC) harboring EGFR mutations. Case Description: We herein describe a 63-year-old man who presented to the emergency department with a 1-week history of speech disturbance and was diagnosed with clinical stage T1cN2M1b, IVA NSCLC with an EGFR exon 21 L858R mutation. The patient underwent brain tumor resection followed by stereotactic radiosurgery and was treated with palliative lazertinib for 6 months. A radiologic complete response was observed in follow-up imaging, and salvage surgery was recommended after multidisciplinary consultation. Right upper lobectomy with mediastinal lymph node dissection revealed a pathologic complete response with no residual tumor cells. The patient remained disease-free for 1 year following lazertinib treatment. Conclusions: This case suggests that salvage surgery after treatment with lazertinib may be a safe and effective approach for NSCLC with common EGFR mutations.