OncoTargets and Therapy (Aug 2020)
Durable Clinical Response of Advanced Lung Adenocarcinoma Harboring EGFR-19del/T790M/BRAFV600E Mutations After Treating with Osimertinib and Dabrafenib Plus Trametinib: A Case Report
Abstract
Honggang Ding,1,* Zhenjie Zhuang,1,* Jingyi Xie,1 Haifu Huang,2 Zhigang Tao,3 Zhanhua Liu4 1Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 2Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, People’s Republic of China; 3Mygene Medical Technology, Guangzhou, People’s Republic of China; 4Department of Cancer Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhanhua Liu Email [email protected]: EGFR-T790M and BRAFV600E are the common resistance mechanisms to EGFR-tyrosine kinase inhibitors (TKIs). Standard treatment for the triple mutations of EGFR-19del, T790M, and BRAFV600E is still under debate. Herein, we present a case of therapeutic efficacy of osimertinib and dabrafenib plus trametinib on a 63-year-old man with advanced lung adenocarcinoma. This patient reached a remarkable progression-free survival of 9 months without any serious adverse reaction. At the progression of the disease, C797S mutation in cis was detected by liquid biopsy. Subsequently, brigatinib with cetuximab was administered but no curative effect was observed. Then, therapy was changed to apatinib combined with osimertinib. The subsequent CT scan showed that the lesions reached stable disease (SD), and the survival benefit has been evaluated. This case showed that the combination treatment of osimertinib and dabrafenib plus trametinib might be a great treatment option for NSCLC patients with triple mutations (EGFR-19del/T790M/BRAFV600E).Keywords: EGFR-19del, T790M, BRAFV600E, EGFR TKI, combination therapy
