A non-small cell lung cancer (NSCLC) patient harboring a rare epidermal growth factor receptor (EGFR) L858R/V843I mutation complex benefited from osimertinib: a case report
Tyrosine kinase inhibitors (TKIs) have greatly improved the survival of non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR)-TKI sensitive mutations such as L858R and exon 19 deletions. The third-generation EGFR-TKI osimertinib, an irreversible TKI, is approved as a therapy for advanced NSCLC with EGFR sensitive mutations. Recently, osimertinib showed antitumor activity against NSCLC in patients harboring an uncommon mutation such as an exon 20 insertion. Herein, we present a patient diagnosed with stage IV NSCLC with an EGFR L858R/V843I mutation complex who benefited remarkably from osimertinib therapy. The patient was a 41-year-old Chinese female who complained of backache in October 2018. Computed tomography (CT) and magnetic resonance imaging (MRI) scans showed a mass in the right lung and brain metastasis. A whole-body bone scan revealed bone metastases. Targeted next-generation sequencing (NGS) of hydrothorax was performed and the coexistence of somatic L858RI and V843I mutations in EGFR exon 21 was discovered on November 13, 2018. Osimertinib therapy (80 mg daily) was administered for 12 months which resulted in an initial partial response (PR). At that point, the right lower lung lesion enlarged, indicating disease progression. Thus, the patient began combination therapy with osimertinib (80 mg daily) and bevacizumab (500 mg daily), leading to disease stabilisation until June 2020. Of note, during treatment, the patient achieved sustained control of metastatic brain and bone lesions. To the best of our knowledge, we report here the first known case of an NSCLC patient with a somatic EGFR L858R/V843I mutation complex who responded well to osimertinib. Our findings provide theoretical guidance and expand the list of potential beneficiaries of EGFR-TKI therapy.
基金:
This work was supported by the Wu Jieping Medical Fund (No. 320.6750.18533).
语种:
外文
PubmedID:
中科院(CAS)分区:
出版当年[2022]版:
大类|4 区医学
小类|4 区卫生保健与服务
最新[2023]版:
无
第一作者:
第一作者机构:[1]Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, China.
通讯作者:
通讯机构:[1]Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, China.[*1]Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunzhou Road, Kunming 650118, China
推荐引用方式(GB/T 7714):
Zhou Yonghong,Qi Xiaofang,Wang Yan,et al.A non-small cell lung cancer (NSCLC) patient harboring a rare epidermal growth factor receptor (EGFR) L858R/V843I mutation complex benefited from osimertinib: a case report[J].Annals of palliative medicine.2022,11(3):1121-1125.doi:10.21037/apm-21-2653.
APA:
Zhou Yonghong,Qi Xiaofang,Wang Yan,Dong Hui&Zhuang Li.(2022).A non-small cell lung cancer (NSCLC) patient harboring a rare epidermal growth factor receptor (EGFR) L858R/V843I mutation complex benefited from osimertinib: a case report.Annals of palliative medicine,11,(3)
MLA:
Zhou Yonghong,et al."A non-small cell lung cancer (NSCLC) patient harboring a rare epidermal growth factor receptor (EGFR) L858R/V843I mutation complex benefited from osimertinib: a case report".Annals of palliative medicine 11..3(2022):1121-1125