Evidence map›Paper›PMID 41494833›Full record

ArticleThoracic cancer2026

Multiple Primary Lung Cancer With Driver Gene Mutations: Is Targeted Therapy Always the Optimal Choice?-A Case Report.

Zi-Rui Ren, Lv Wu, Chang Lu, Fen Wang, Ying-Long Peng, Dong-Xuan Cai, Li-Bo Tang, Jia-Ting Li, Zhi Guo, Zhi-Hong Chen and 6 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Thoracic cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Zi-Rui RenGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.ORCID https://orcid.org/0009-0007-6502-9380
Lv WuGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Chang LuGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Fen WangGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Ying-Long PengGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.ORCID https://orcid.org/0000-0002-7162-4422
Dong-Xuan CaiGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.ORCID https://orcid.org/0000-0003-4609-7031
Li-Bo TangGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.ORCID https://orcid.org/0000-0002-4870-4408
Jia-Ting LiGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Zhi GuoGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.ORCID https://orcid.org/0000-0001-5796-1185
Zhi-Hong ChenGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Yu DengGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Lu SunDepartment of Pathology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Xue-Wu WeiGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Qian-Lin HuangGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Chong-Rui XuGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.ORCID https://orcid.org/0000-0002-3474-2809
Qing ZhouGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.

Funding

Guangdong Provincial Key Lab of Translational Medicine in Lung Cancer 2017B030314120Guangdong Provincial Science and Technology Planning Project 2023B110009Guangzhou Science and Technology Program 2025A03J4506MOE Changjiang Distinguished Professor Supporting Project KY0120240205National Natural Science Foundation of China 82303643
6 · The paper itself

Abstract

Targeted therapy is the standard treatment for driver-mutated lung cancer, but its efficacy in multiple primary lung cancers (MPLCs) remains limited due to significant inter-lesional molecular heterogeneity. We present a case of synchronous MPLC with 34 bilateral pulmonary nodules. The dominant right upper lobe lesion was an EGFR L858R-mutated adenocarcinoma that responded to osimertinib, while other nodules progressed. Switching to chemoimmunotherapy induced regression of all lesions, enabling surgical resection. Postoperative pathological analysis revealed two resected lesions with discordant molecular profiles-one EGFR-mutated and one driver-negative. Despite adjuvant therapy, the patient developed early recurrence as non-small cell lung carcinoma-not otherwise specified with no driver mutation and died within 6 months post-radiotherapy. This case highlights the limitations of single-agent targeted therapy in MPLC, challenges the assumption that driver-negative lesions typically follow an indolent course, and supports early chemotherapy-based systemic combination strategies to address the significant molecular heterogeneity in MPLC.

Indexed as

Lung NeoplasmsMolecular Targeted TherapyMutationNeoplasms, Multiple PrimaryHumanscase reportdriver gene mutationmolecular heterogeneitymultiple primary lung cancertargeted therapy

Identifiers

PMID41494833
PMCPMC12774582

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.