Benefit from a high dose of gefitinib in a woman with lung adenocarcinoma and an epidermal growth factor receptor tyrosine-kinase acquired mutation.

Over the last 10 years, the approach to the treatment of cancer has changed significantly due to an improved understanding of the processes that regulate tumor growth and development. Targeted strategies act against various neoplasms, alone or in combination with conventional therapy, while avoiding most of the toxicities induced by standard chemotherapy and radiotherapy. Promising targets include members of the human epidermal receptor (HER) family, such as epidermal growth factor receptor (HER1/EGFR). Many EGFR-targeted agents, especially tyrosine-kinase inhibitors (TKIs), are being developed for the treatment of advanced non-small cell lung cancer (NSCLC) in which EGFR shows an activating mutation in the tyrosine-kinase domain. Mutations seem to be clinically relevant as they are most frequent in non-smokers, adenocarcinomas, women and Japanese patients, features related to a radiographic response to TKIs. Here, we report the management of a stage IV adenocarcinoma of the lung in a young non-smoking woman treated with gefitinib whose tumor developed EGFR-TKI resistance.