OncoTargets and Therapy (Feb 2020)
An EGFR-Amplified Cervical Squamous Cell Carcinoma Patient with Pulmonary Metastasis Benefits from Afatinib: A Case Report
Abstract
Qian Chen, 1,* Yihua Huang, 1, 2,* Lin Shao, 3 Han Han-Zhang, 3 Fan Yang, 3 Yang Wang, 3 Jing Liu, 3 Jiadi Gan 2 1School of Nursing, Xinhua College of Sun Yat-sen University, Guangzhou 510520, People’s Republic of China; 2Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of China; 3Burning Rock Biotech, Guangzhou 510300, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qian ChenSchool of Nursing, Xinhua College of Sun Yat-sen University, Guangzhou 510520, People’s Republic of ChinaEmail [email protected] GanDepartment of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of ChinaTel +86-20-87342480Email [email protected]: Currently, women with metastatic or recurrent cervical cancer still have very limited treatment options. Despite the rapid advancements in targeted therapies, no targeted therapy was approved for cervical cancer, except for bevacizumab. In the present study, we reported a 52-year-old heavily pre-treated EGFR amplified patient with metastatic cervical squamous cancer who benefited from afatinib with a progression-free survival (PFS) of 5.5 months. The patient was administered with a first-line treatment of chemotherapy and bevacizumab with a PFS of 4.3 months. Subsequently the patient was treated with a second-line regimen of angiogenesis inhibitor apatinib plus chemotherapy and a third-line treatment of pembrolizumab. Genomic profiling revealed significant EGFR amplification in both primary (copy number [CN] =15.9) and metastatic lesions (CN =18). Afatinib monotherapy was then administered as the fourth-line regimen. She achieved partial response (PR) with a PFS of 5.5 months. At disease progression, the CN of EGFR was elevated to 39.9 accompanied by the emergence of PIK3CA amplification (CN =4.2). The patient was treated with everolimus and afatinib and achieved stable disease (SD) after 3 months. To the best of our knowledge, this is the first clinical evidence of an EGFR-amplified metastatic cervical cancer patient benefiting from afatinib as a single agent.Keywords: afatinib, EGFR amplification, cervical squamous carcinoma, EGFR-tyrosine kinase inhibitor, next-generation sequencing
