Pemetrexed and cisplatin followed sequentially by gefitinib as neo-adjuvant therapy for stage IIB EGFR-mutation-positive lung adenocarcinoma patient: a case report and literature review

Early-stage non-small-cell lung cancer (NSCLC) patients with EGFR mutation positive have a poor prognosis even after complete resection, which raised growing demands for multimodal therapies. Sequential therapy with chemotherapy and EGFR-TKI for advanced EGFR mutation-positive NSCLC patients significantly prolonged PFS, but there has been no report of the efficacy and complications of it in neo-adjuvant therapy for early stage NSCLC patients with EGFR mutation positive. In this paper, the case of a 64-year-old Chinese female patient diagnosed with stage IIB lung cancer harboring EGFR mutation-positive was presented. After two cycles of neo-adjuvant therapy with pemetrexed and cisplatin followed sequentially by gefitinib, the primary lesion was remarkably shrunk. The patient underwent tumor resection and systematic mediastinal lymph node dissection followed by two cycles of adjuvant chemotherapy. The patient had been followed up for 37 months after adjuvant chemotherapy without recurrence or any other complication. And during this period, she didn’t receive any anti-cancer therapy. In conclusion, pemetrexed plus cisplatin followed sequentially by gefitinib as neo-adjuvant therapy is effective and safe for early stage NCLC patients with EGFR mutation.