After receiving third-generation targeted therapy at HCG Cancer Hospital in Kolkata, a septuagenarian whose Stage IV lung cancer had spread widely to her bones, resulting in fractures in both upper arms, has regained her independence and achieved a PET-CT-confirmed, complete metabolic response.

The case, which was brought to light on August 1st, World Lung Cancer Day, highlights how molecular testing can help find mutation-guided treatment options even in cases where the cancer has spread widely.

Her weakened bones caused pathological fractures, which led to the accidental discovery of cancer. A comparatively small tumor in the right lung was discovered by PET-CT scans, but there were numerous metastases to the skull, spine, ribs, pelvis, and limbs. A biopsy revealed metastatic lung adenocarcinoma, and the fractures were surgically stabilized.

Doctors were able to begin oral targeted therapy with dacomitinib after next-generation sequencing identified an EGFR mutation. The patient initially responded well, but scans revealed increased activity in the bones about 18 months later. Treatment was switched to osimertinib, a third-generation targeted medication, after a multidisciplinary tumor-board review. Axonal neuropathy was revealed by nerve-conduction studies, and the patient later experienced neurological weakness. With intravenous immunoglobulin therapy and neuro-supportive care, she gradually recovered. She can now walk, cook, and carry out her everyday tasks on her own after her most recent PET-CT revealed a full metabolic response.

“We were able to choose targeted oral therapy after molecular testing revealed a treatable mutation. A tumor-board decision was used to modify treatment as the illness worsened. The patient has recovered her independence despite widespread bone metastases and a neurological setback,” said Dr. Sanchayan Mandal, Senior Consultant, Medical Oncology, HCG Cancer Hospital, Kolkata.

“At every stage, advanced cancer care needs to be ready for new challenges. This case demonstrates how coordinated teams can adjust treatment as the disease progresses, manage complications, and help the patient regain independence,” said Dr. Rupali Basu, RBH, HCG Cancer Hospitals.

A great achievement indeed.

Priyanka Dutta