OncoTargets and Therapy (Aug 2020)

Three Novel EGFR Mutations (750_758del, I759S, T751_I759delinsS) in One Patient with Metastatic Non-Small Cell Lung Cancer Responding to Osimertinib: A Case Report

  • Li H,
  • Yu T,
  • Lin Y,
  • Xie Y,
  • Feng J,
  • Huang M,
  • Guo A,
  • Liu X,
  • Yin Z

Journal volume & issue
Vol. Volume 13
pp. 7941 – 7948

Abstract

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Huiying Li,1 Tingting Yu,1 Yongjuan Lin,1 Yu Xie,1 Jie Feng,1 Mingmin Huang,1 Aibin Guo,1 Xiangyu Liu,2 Zhenyu Yin1 1Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China; 2Department of Neurosurgery, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of ChinaCorrespondence: Zhenyu Yin Department of Geriatric OncologyAffiliated Nanjing Drum Tower Hospital of Nanjing University Medical School Tel +8613913904579Email [email protected] LiuDepartment of Neurosurgery, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School Tel +8613851672018Email [email protected]: Generations of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) can significantly improve the outcome of EGFR-positive NSCLC patients. However, acquired TKIs-resistant mutations are inevitable. Except the common EGFR alterations, more and more rare mutations are revealed by next-generation sequencing (NGS), the clinical significance of which are still unclear. Here, we report an advanced lung adenocarcinoma patient who harbored two novel EGFR exon 19 deletions (750_758del and I759S) at the beginning and exhibited a short response to icotinib for 7.0 months. Then, secondary resistance EGFR T751_I759delinsS occurred. Chemotherapy combined with bevacizumab and erlotinib was administered in turn but failed. Standard-dose osimertinib (80 mg daily) obtained durable clinical remission for 16 months, and high-dose osimertinib (160 mg daily) further prolonged the survival of 9 months after leptomeningeal metastases (LM) occurring. This study presented the first case of intractable terminal NSCLC in a patient with EGFR 750_758del, I759S and T751_I759delinsS mutations, who responded positively to osimertinib and achieved a prolonged OS of 52 months, providing a potential therapeutic option for the patients harboring these particular EGFR mutations.Keywords: non-small cell lung cancer, EGFR, 750_758del, I759S, T751_I759delinsS, osimertinib

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