Role of allogeneic natural killer T cells in the treatment of a patient with gefitinib-sensitive lung adenocarcinoma

Plain language summary As one of the EGFR tyrosine kinase inhibitors used clinically, gefitinib has achieved good efficacy in patients with EGFR mutation-positive non-small-cell lung cancer (NSCLC), though eventual drug resistance is inevitable. Currently, the efficacy of anti-PD-1/anti-PD-L1 immunotherapy has not been demonstrated in NSCLC because of the low expression of PD-1 in this disease. Thus new strategies for NSCLC treatment need to be further explored. Here we report a patient with advanced lung adenocarcinoma with the EGFR mutation, who was treated with chemotherapy and bevacizumab and sequential gefitinib combined with allogeneic haploidentical natural killer T cells, who achieved a surgical opportunity and long-term survival. To delay the time to resistance to gefitinib, a combination of allogeneic haploidentical CD8(+) CD56(+) natural killer T cells and gefitinib may offer a viable treatment option for patients with EGFR mutation-positive NSCLC. Gefitinib has shown good efficacy in patients with EGFR mutation-positive non-small-cell lung cancer, but acquired resistance is inevitable. Here we report a patient with an advanced lung adenocarcinoma with the EGFR mutation who achieved surgical opportunity and long-term survival following treatment with chemotherapy and bevacizumab, followed by sequential gefitinib combined with allogeneic haploidentical CD8(+) CD56(+) natural killer T cells. Our case provides a potential effective strategy for delaying acquired gefitinib resistance and extending progression-free survival among patients with non-small-cell lung cancer who harbor common EGFR mutations.

Automated summary

Gefitinib has demonstrated good efficacy in patients with EGFR mutation-positive non-small-cell lung cancer, but the development of acquired resistance is inevitable. This case report presents a potential effective strategy for delaying gefitinib resistance and extending progression-free survival in NSCLC patients with common EGFR mutations by using a combination of allogeneic haploidentical CD8(+) CD56(+) natural killer T cells and gefitinib.