KUN-HUEI YEHShiou-Hwei YehWan J.-P.Ying-Chun ShenANN-LII CHENG2021-01-282021-01-2820050959-4973https://www.scopus.com/inward/record.uri?eid=2-s2.0-23344446097&doi=10.1097%2f01.cad.0000171769.43940.58&partnerID=40&md5=ea2ecb286dec3dea9fce52263642d16ehttps://scholars.lib.ntu.edu.tw/handle/123456789/543530A 61-year-old never-smoker female suffered from adenocarcinoma of the lung with chest wall invasion and peri-adrenal lymph node metastases. After palliative resection of all clinically detectable primary and metastatic adenocarcinoma, she received cisplatin and gemcitabine combination chemotherapy for a total of 3 cycles. New metastatic lesions were found in spleen and para-aortic lymph nodes. Her tumor tissue was subjected to mutation analysis for epidermal growth factor receptor (EGFR) and had been shown to have a T → G missense mutation in nucleotide 2819 of EGFR full-length cDNA (accession no. NM_005228.3), within exon 21 of the EGFR gene, resulting in amino acid substitutions from leucine to arginine at codon 858 (L858R) as expected. She received oral gefitinib 250 mg/day after mutation analysis. She had a very good tumor response with more than 90% tumor reduction shown by abdominal computed tomographic scan, normalization of previously elevated carcinoembryonic antigen level, and complete resolution of previous uptake signals in spleen and para-aortic lymph nodes shown by positron emission tomographic scan. She has been kept in clinical complete remission for 11 + months after the initiation of gefitinib treatment. Our patient supports the proposition that somatic mutation L858R in exon 21 of the EGFR gene accounts for complete responsiveness to gefitinib in a Taiwanese female patient with metastatic adenocarcinoma of lung. ? 2005 Lippincott Williams & Wilkins.[SDGs]SDG3arginine; carcinoembryonic antigen; cisplatin; epidermal growth factor receptor; gefitinib; gemcitabine; leucine; adrenal metastasis; adult; amino acid substitution; article; Asian; cancer invasion; cancer regression; case report; codon; computer assisted tomography; DNA sequence; drug eruption; drug response; drug sensitivity; dry skin; exon; female; follow up; gene mutation; histopathology; human; human tissue; lung adenocarcinoma; lymph node metastasis; missense mutation; nucleotide sequence; palliative therapy; paraaortic lymph node; paronychia; pharmacogenetics; polymerase chain reaction; positron emission tomography; priority journal; spleen cancer; Taiwan; thorax wall; Adenocarcinoma; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Asian Continental Ancestry Group; Cisplatin; Deoxycytidine; DNA Mutational Analysis; Female; Humans; Lung Neoplasms; Middle Aged; Point Mutation; Polymerase Chain Reaction; Quinazolines; Receptor, Epidermal Growth Factorjournal article10.1097/01.cad.0000171769.43940.58160275222-s2.0-23344446097