Osimertinib as Salvage Therapy in Advanced Non‐Small Cell Lung Cancer After Aumolertinib Resistance With T790M Mutation: A Case Report

Abstract

ABSTRACT The third generation of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) is recommended universally as the standard treatment for non‐small cell lung cancer (NSCLC) carrying the EGFR T790M mutation. With the approval of multiple third‐generation EGFR‐TKIs, questions have arisen regarding the differences in their efficacy and how to select the most appropriate agent for individual patients. The study reports a case of an advanced NSCLC patient with multiple brain metastases. The patient initially received the pemetrexed plus carboplatin (PC) regimen for 5 months and displayed stable disease. Upon disease progression, the patient was treated with aumolertinib as second‐line treatment due to the detection of EGFR L858R and T790M mutations, but the symptoms of brain metastases deteriorated. Switching to osimertinib successfully relieved the patient's symptoms and achieved a long progression‐free survival (PFS) of nearly 2 years. Leptomeningeal metastasis was then definitively diagnosed, and the patient eventually died approximately 4 months after osimertinib resistance. This case suggests that osimertinib may be a viable option for EGFR‐mutant NSCLC patients after aumolertinib failure, especially for those with intracranial metastases.

Keywords

• aumolertinib
• epithelial growth factor receptor
• osimertinib
• resistance