Gefitinib effectively treated advanced lung cancer with a rare EGFR L747P mutation in a kidney transplant recipient: the first case report

Abstract Allograft kidney transplantation is considered to be the best treatment for end-stage renal disease, which can both improve the quality of life and prolong the life of patients. The inevitable use of immunosuppressants after kidney transplantation is highly associated with De Novo malignancies, which are currently the second cause of death among kidney transplant recipients (KTRs). Previous studies have shown that lung cancer accounts for 3–7% of new malignancies after kidney transplantation. It is well known that the first-line treatment for epidermal growth factor receptor (EGFR) positive advanced non-small cell lung cancer (NSCLC) in the general population is tyrosine kinase inhibitors (TKIs), and this principle also applies to KTRs. But L747P is a rare EGFR mutation in EGFR Exon 19 and the response of patients with EGFR L747P to TKIs remains controversial. Here we report a kidney transplant recipient with advanced lung adenocarcinoma harboring EGFR L747P mutation who benefited from the first-line treatment of gefitinib.