Empirical gefitinib response in mutation-negative lung adenocarcinoma with comorbidities: A case report

Lung adenocarcinoma, a subtype of non-small cell lung cancer (NSCLC), poses a significant therapeutic challenge in patients with negative driver mutations, poor performance status, and advanced disease. This case report describes a 65-year-old non-smoker female with Stage IV mutation-negative lung adenocarcinoma, Type 2 diabetes, and chronic obstructive pulmonary disease, who presented with respiratory failure and Eastern Cooperative Oncology Group Performance Status 3. Molecular profiling confirmed the absence of targetable mutations. Due to her poor general condition, empirical therapy with gefitinib was initiated, alongside zoledronic acid for bone metastases. Remarkable clinical and radiologic improvements were observed after 3 months of therapy, with resolution of primary and metastatic lesions. This exceptional response highlights the potential utility of tyrosine kinase inhibitors (TKIs) in mutation-negative NSCLC, despite deviations from standard guidelines. While this single case underscores the importance of personalized, patient-centric approaches, further studies are needed to explore the role of empirical TKI therapy in this subgroup.