Case Report: Osimertinib achieved remarkable and sustained disease control in an advanced non-small-cell lung cancer harboring EGFR H773L/V774M mutation complex

Lung Cancer. 2018 Jul:121:1-4. doi: 10.1016/j.lungcan.2018.04.006. Epub 2018 Apr 5.

Abstract

Missense mutations in EGFR exon 20 are rare in non-small-cell lung cancer (NSCLC), and mostly insensitive to the first generation tyrosine kinase inhibitors (TKIs) of EGFR. However, their responses to the third generation TKI are unclear. Here, we reported a patient with advanced NSCLC harboring a rare EGFR H773L/V774M mutation complex. Although he was irresponsive to the first generation TKI gefitinib, he demonstrated sustained disease control to osimertinib, suggesting that this complex is an activating mutation of EGFR and can be suppressed by osimertinib. The follow-up genetic profiling revealed multiple acquired new mutations that might be related to his resistance to osimertinib. This finding would provide valuable experience for future treatment of the same mutations.

Keywords: Complex mutations; EGFR; Non-small cell lung cancer; Osimertinib; Tyrosine kinase inhibitors.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acrylamides
  • Aniline Compounds
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • DNA Mutational Analysis
  • Drug Resistance, Neoplasm / genetics
  • ErbB Receptors / genetics
  • Female
  • Follow-Up Studies
  • Gefitinib / therapeutic use
  • Humans
  • Lung Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Mutation, Missense / genetics*
  • Neoplasm Staging
  • Piperazines / therapeutic use*
  • Protein Kinase Inhibitors / therapeutic use*

Substances

  • Acrylamides
  • Aniline Compounds
  • Antineoplastic Agents
  • Piperazines
  • Protein Kinase Inhibitors
  • osimertinib
  • EGFR protein, human
  • ErbB Receptors
  • Gefitinib