Is capecitabine a new choice of treatment for lung adenocarcinoma? A case report involving partial response in second line of treatment and hypothesis of the biological basis

In lung cancer different histologies have different biologies. Active agents in non-small-cell lung cancer (NSCLC) include platinums, paclitaxel, docetaxel, gemcitabine, erlotinib, pemetrexed and vinorelbine. We report a case of a patient with metastatic lung adenocarcinoma with high levels of LDH and CEA with clear partial response to capecitabine after several lines of chemotherapy. The increase in thymidine phosphorylase (TP) expression in NSCLC could provide a rationale for the use of capecitabine in this tumour. More research is needed to try to explain the striking activity of capecitabine in this patient with lung adenocarcinoma and high levels of CEA and to find molecular targets to predict the response to this agent.