REVIEW article
Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Triple Metachronous Primary Malignancies: A Case Report of NGS-Guided Multidisciplinary Management and literature review
Provisionally accepted
Xiangxue Li
Lihua ZhangXiaowei WangJing Lv
Caiqi LiuSiyi Zhang
Xiaoxuan LiJialin Song
Wensheng Qiu
Shufen Zhao*- The Affiliated Hospital of Qingdao University, Qingdao, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Rationale: Although the incidence of multiple primary malignancies (MPM) is increasing, triple primary malignancies (TPM) remain extremely rare. The pathogenesis of MPM is currently unclear, and there is a lack of optimal management strategies. Herein, we report a case of metachronous TPM involving both the respiratory tract and the digestive tract. Objective: This report aims to analyze the clinical characteristics of the patient and emphasize the significant role of next-generation sequencing (NGS) and multidisciplinary team (MDT) in the management of MPM. Diagnoses and interventions: A 72-year-old male patient was diagnosed with a lung cancer and underwent surgical resection. Two years later, he was diagnosed with synchronous gastric cancer, rectal cancer, and bilateral pulmonary metastases. Guided by NGS and multiple MDT consultations, the patient received four cycles of individualized neoadjuvant chemotherapy combined with targeted therapy, followed by radical resection and postoperative adjuvant chemotherapy alongside targeted treatment. Currently, the patient's pulmonary metastatic lesions are being managed with ongoing targeted therapy. Outcomes: The patient currently maintains a good quality of life. During the follow-up period, no recurrence or metastasis of gastric or rectal cancer was observed, and the bilateral lung metastases showed a sustained partial response. Conclusions: The management of TPM is considerable complex. MDT guided by NGS can be instrumental in formulating optimal, personalized treatment strategies for such patients, which may contribute to improved clinical outcomes and quality of life.
Keywords: case report, Multidisciplinary team, Multiple primary malignancies, Next-generation sequencing, Triple Metachronous Primary Malignancies
Received: 14 Sep 2025; Accepted: 03 Feb 2026.
Copyright: © 2026 Li, Zhang, Wang, Lv, Liu, Zhang, Li, Song, Qiu and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shufen Zhao
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.