OncoTargets and Therapy (Oct 2020)
Great Efficacy of Afatinib in a Patient with Lung Adenocarcinoma Harboring EGFR L833V/H835L Mutations: A Case Report
Abstract
Xiang Long,1 Tian Qin,2 Junhong Lin3 1Department of Respiratory Medicine, Peking University Shenzhen Hospital, Shenzhen, 518036, China; 2Burning Rock Biotech, Guangzhou, 510300, China; 3Department of Respiratory Medicine, Huizhou Municipal Central Hospital, Huizhou, 516001, ChinaCorrespondence: Junhong Lin Department of Respiratory MedicineHuizhou Municipal Central Hospital, No. 41, West Eling Road, Huicheng District, Huizhou 516001, ChinaEmail [email protected]: Uncommon mutations account for 10– 15% of epidermal growth factor receptor (EGFR) mutations in patients with non-small-cell lung cancer (NSCLC). Most of them are proved to be sensitive or resistant to EGFR-tyrosine kinase inhibitors (TKIs). However, there is insufficient evidence for other less common types of EGFR mutations, such as complex mutations. Here, we present a 65-year-old never-smoking male who was diagnosed with stage IV lung adenocarcinoma. A rare L833V/H835L complex mutation in exon 21 of EGFR was detected in plasma and pleural effusion by next generation sequencing (NGS). Afatinib was used as first-line therapy and showed very good efficacy. To date, the patient is still benefited from afatinib treatment for a total of 10 months, with no signs of disease progression. Our case suggests that a comprehensive screening for EGFR mutations should be conducted before treatment in clinical practice, and afatinib could be a first-line treatment option in NSCLC patients harboring H833V/H835L mutations.Keywords: non-small-cell lung cancer, epidermal growth factor receptor, afatinib, EGFR compound mutation, L833V/H835L
