Long-term survival in a patient with advanced non-smoking lung adenocarcinoma and no EGFR mutation after comprehensive therapy with EGFR-TKI-based therapy: A case report

RATIONALE: This is the first known report to describe a case of advanced non-smoking lung adenocarcinoma with no epidermal growth factor receptor mutation after comprehensive epidermal growth factor receptor-tyrosine kinase inhibitor-based therapy that survived for nearly 12 years. PATIENT CONCERNS: A 48-year-old Chinese woman that came to our hospital with a left supraclavicular mass. DIAGNOSIS: The final diagnosis was left lung adenocarcinoma with left supraclavicular lymph node metastasis, cT1N3M0 IIIB (International association for the Study of lung cancer 6th version). INTERVENTIONS: After 4 months of 4 cycles of chemotherapy, gefitinib was administered alone for 5.5 years. Local radiotherapy (40GY/20F) was administered for 1 month, and osimertinib alone was followed for 4.5 years. A combination of pemetrexed with oxaliplatin and hyperthermia at the same time was administered for 4 cycles. Toripalimab and anlotinib were administered for 3 months. Since then, the patient had been taking a double dose of icotinib herself. OUTCOMES: The patient has survived for nearly 12 years since diagnosis of lung cancer. LESSONS: Our case is of significant importance to clinicians involved in the treatment of patients with advanced nonsmoking lung adenocarcinoma and no epidermal growth factor receptor mutations.