title: Pathological complete response to gefitinib in a 10-year-old boy with EGFR-negative pulmonary mucoepidermoid carcinoma: a case report and literature review.
abstract: OBJECTIVE
  Pulmonary Mucoepidermoid carcinoma (MEC) accounts for 0.1-0.2% of all lung cancer. It occurred in the 3-78 years old, and 50% patients younger than 30. MEC has no standard treatment, but recently reports indicated MEC without epidermal growth factor receptor (EGFR) mutations sensitive to gefitinib.
  
  
  OBJECTIVE
  To explore a new standard treatment strategy for MEC, after reviewed literature related to MEC, we used Gefitinib to treatment a patient with EGFR-negative MEC, and observe its effects.
  
  
  METHODS
  10-year-old boy was diagnosed with low-grade MEC by bronchial lung biopsy, EGFR gene mutation test was negative. Gefitinib was administered as neoadjuvant therapy at 125 mg daily.
  
  
  RESULTS
  The patient underwent right middle lobe, lower lobe resection and mediastinal lymph node dissection. After surgery, the patient had gained weight (5 kg) after 18 days of gefitinib therapy. A CT scan of the chest 1 month after surgical resection showed no recurrence, and followed for 22 months after treatment without tumour recurrence, suggesting that the patient was completely cured.
  
  
  CONCLUSIONS
  Gefitinib has potential to become a standard treatment for pulmonary MEC patients, including pediatric patients. However, the mechanisms need further investigation.
authors.affiliation: Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Shaomei
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
authors.affiliation: Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: He
authors.affiliation: Clinical Laboratory, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Clinical Laboratory, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Ma
authors.affiliation: Department of Molecular Pathology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Yuxi
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Molecular Pathology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Wei
authors.affiliation: Department of Molecular Pathology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ma
authors.affiliation: Research Service Office, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.|Department of Pathophysiology, School of Basic Medical Science, Zhengzhou University, Zhengzhou, 450001, China.
authors.forename: Kangdong
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Ma
authors.affiliation: Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
authors.forename: Qiming
authors.initials: Q
authors.lastname: Wang
mesh_terms: D018277:Carcinoma, Mucoepidermoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000235:genetics* / Q000601:surgery; D002648:Child; D004268:DNA-Binding Proteins / Q000235:genetics; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D009154:Mutation; D020360:Neoadjuvant Therapy / Q000379:methods; D009367:Neoplasm Staging; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000008:administration & dosage / Q000494:pharmacology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014157:Transcription Factors; D016896:Treatment Outcome
chemical_list: C500984:CRTC1 protein, human; D004268:DNA-Binding Proteins; C430872:MAML1 protein, human; D015514:Oncogene Proteins, Fusion; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D014157:Transcription Factors; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib
keywords: CRTC1-MAML2; EGFR-TKI; lung cancer; mucoepidermoid carcinoma; pediatric