Personalized Therapy in the Management of Non Small Cell Lung Cancer

Case Report

Austin J Cancer Clin Res 2015;2(5): 1045.

Personalized Therapy in the Management of Non Small Cell Lung Cancer

Nabil Mobarek¹* and Ahmed Abdel-Halim Khaleefa²

¹Department of Clinical Oncology, Menoufeya University, Egypt

²Maadi Military Hospital, Egypt

*Corresponding author: Nabil Mobarek, Department of Clinical Oncology, Menoufeya University, Menofia Governorate, Egypt.

Received: May 13, 2015; Accepted: June 02, 2015; Published: July 27, 2015


Lung cancer has been the leading cause of cancer death among men in the United States for years, and since 1988, it has become the number-one cause of cancer death among women. An estimated 222,520 new cases of lung cancer are expected in 2010, and 157,300 deaths due to this disease are expected to occur, roughly 28% of all cancer deaths. She is a 64 female lady, a known case of Non Small Cell Lung Cancer, where she received concurrent Chemotherapy and Radiotherapy, followed by maintenance Chemotherapy for almost 10 months. She achieved a very good Response rate, plus survival benefit together with improving quality of life.

Keywords: Non Small Cell Lung Cancer; Pemetrexed; Maintenance; Adenocarcinoma


In the past, radiation therapy was considered the standard therapy for patients with stage IIIA or IIIB disease. Long-term survival was poor, in the range of 5%, with poor local tumor control and early development of distant metastatic disease. At least 11 randomized trials have compared thoracic irradiation alone with chemo-radiation therapy in patients with stage III NSCLC. Several meta-analyses have demonstrated a small, but statistically significant, improvement in survival with the combined-modality regimens [1,2]. Pemetrexed continuation maintenance therapy is well-tolerated and offers superior overall survival compared with placebo, further demonstrating that it is an efficacious treatment strategy for patients with advanced non-squamous NSCLC and good performance status who did not progress during pemetrexed-cisplatin induction therapy [3].

Case Presentation

Mrs. DS, a 64 years old lady, is a known case of Right Lung Cancer (Grade III Adenocarcinoma), Stage III B, since September 2013 (Figure 1). CT scan of the chest showed an irregular cavitating lesion of the lower lobe of the left lung, associated with large right upper lobe parenchymal nodule. She received 4 cycles of Pemetrexed /Cisplatinum (PEM 500mg/m2, Cis 70mg/m2), once every 3 weeks, after which she achieved Partial Response. A PET-CT scan done in November 2013 showed further mass lesion regression.