Exceptionally Long-Term Survival in Non-Small Cell Lung Cancer with Dual EGFR Mutations: Exon 19 Deletion and G719X — A Case Report
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Abstract
Non-small cell lung cancer (NSCLC) remains one of the leading causes of cancer-related mortality worldwide. The discovery of activating mutations in the epidermal growth factor receptor (EGFR) gene has transformed targeted therapy, providing significant clinical benefit in selected patient populations. Nevertheless, survival beyond 10 years remains exceptionally rare. Although compound EGFR mutations are uncommon, emerging evidence suggests that such combinations can profoundly affect therapeutic efficacy, resistance patterns, and clinical outcomes.
We report the case of an Azerbaijani male who was diagnosed at the age of 69 years with stage IIIA lung adenocarcinoma, and who is currently 79 years old after achieving long-term survival. Following multimodal treatment—including EGFR tyrosine kinase inhibitor (TKI) therapy, chemotherapy, radiotherapy, and surgery—durable disease control has been achieved for over a decade. Serial ^18F-FDG PET-CT imaging and circulating tumor DNA (ctDNA) monitoring have confirmed sustained remission and molecular stability, with no evidence of emergent resistance mutations.
This case underscores the potential for exceptionally long-term survival in NSCLC patients with compound EGFR mutations managed with a comprehensive, molecularly guided therapeutic strategy. It also highlights the importance of evaluating hereditary cancer predisposition in such clinical contexts.
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