Real-World Data & Evidence for Life Sciences

Date: March 14, 2026
Author: Dr. R. Patel, MD · Medical Oncology
Source: Lambda EHR · Note ID 8847221
Visit: Outpatient Follow-Up

Diagnosis

Non-small cell lung cancer, adenocarcinoma, Stage IIIB, right upper lobe primary. Dx confirmed via CT-guided biopsy 11/2025.

Molecular & biomarker testing

Comprehensive genomic profiling panel (12/2025): EGFR exon 21 L858R mutation detected, allele frequency 42%. ALK/ROS1 negative by FISH. KRAS wild-type. PD-L1 by IHC (22C3): TPS 72%, a high expressor. MSI-stable.

Treatment history

Line 1 (10/2025–01/2026): Carboplatin AUC5 + Pemetrexed 500 mg/m² × 4 cycles. Discontinued after cycle 4 due to Grade 3 thrombocytopenia (nadir PLT 28K); patient declined further platinum.

Line 2 (current, 02/12/2026): Osimertinib 80 mg orally daily. Cycle 2 Day 30.

Performance & imaging

ECOG Performance Status: 1. Ambulatory, self-care intact. Partial response: RUL mass 3.2 cm → 2.2 cm (−31%) per RECIST 1.1, 03/10/2026.

Assessment & plan

Continue osimertinib at current dose; tolerating well. Repeat CT chest/abdomen in 8 weeks with labs q4w. Discussed clinical trial options should progression occur; patient interested in

7 of 7 variables extracted

Stage IIIB
EGFR variant L858R (Ex21) · VAF 42%
PD-L1 TPS 72% (high)
Prior Tx Carbo+Peme ×4 · disc. G3
Current Tx Osimertinib 80mg
ECOG 1
Best response PR (−31%)

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