Lung Adenocarcinoma Harboring Triple Rare EGFR Exon 18 Mutations Rapidly Developed Resistance to Multiple Therapies

Anticancer Section / Original Paper

Liu Y. · Wu Y. · Wu F. · Hu C.

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Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China

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Article / Publication Details

First-Page Preview

Abstract of Anticancer Section / Original Paper

Received: January 21, 2022
Accepted: June 14, 2022
Published online: June 28, 2022

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: https://www.karger.com/CHE

Abstract

There is no standard therapy for nonsmall-cell lung cancer harboring rare coexistent EGFR mutations. Here, we report a female patient who was diagnosed as lung adenocarcinoma with three mutations of G724S, E709K, and V689I in exon 18. The patient responded to, but also showed rapid development of resistance to multiple therapies, including a second-generation EGFR-TKI of afatinib, a platinum-based doublet chemotherapy, and a multiple target TKI of anlotinib. As such, she ended up with a short overall survival time. Further research is required to understand the resistance mechanism(s) of these complex gene mutations.

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References Chiu CH, Yang CT, Shih JY, Huang MS, Su WC, Lai RS, et al. Epidermal growth factor receptor tyrosine kinase inhibitor treatment response in advanced lung adenocarcinomas with g719x/l861q/S768I mutations. J Thorac Oncol. 2015;10(5):793–9. Cho JH, Lim SH, An HJ, Kim KH, Park KU, Kang EJ, et al. Osimertinib for patients with non-small-cell lung cancer harboring uncommon EGFR mutations: a multicenter, open-label, phase II trial (KCSG-LU15-09). J Clin Oncol. 2020;38(5):488–95. Li J, Wang Z, Groen HJM, Zhao J, Wang P, Zhang C, et al. Uncommon EGFR G724S mutations arise in non-small-cell lung cancer patients with acquired resistance to first-generation EGFR-TKIs. Lung Cancer. 2018;118:173–5. Yang JCH, Sequist LV, Geater SL, Tsai CM, Mok TSK, Schuler M, et al. Clinical activity of afatinib in patients with advanced non-small-cell lung cancer harbouring uncommon EGFR mutations: a combined post-hoc analysis of LUX-Lung 2, LUX-Lung 3, and LUX-Lung 6. Lancet Oncol. 2015;16(7):830–8. Yang JCH, Schuler M, Popat S, Miura S, Heeke S, Park K, et al. Afatinib for the Treatment of NSCLC harboring uncommon EGFR mutations: a database of 693 cases. J Thorac Oncol. 2020;15(5):803–15. Frega S, Conte P, Fassan M, Polo V, Pasello G. A triple rare E709K and L833V/H835L EGFR mutation responsive to an irreversible pan-HER inhibitor: a case report of lung adenocarcinoma treated with afatinib. J Thorac Oncol. 2016;11(5):e63–4. Zeng L, Zhang Y, Yang N. EGFR exon 18 DelE709_T710insD as an acquired resistance mechanism to afatinib in an advanced EGFR exon 18 E709H lung adenocarcinoma. J Thorac Oncol. 2018;13(6):e93–5. Lei L, Wang WX, Zhu YC, Li JL, Fang Y, Wang H, et al. Potential mechanism of primary resistance to icotinib in patients with advanced non-small cell lung cancer harboring uncommon mutant epidermal growth factor receptor: a multi-center study. Cancer Sci. 2020;111(2):679–86. Article / Publication Details

First-Page Preview

Abstract of Anticancer Section / Original Paper

Received: January 21, 2022
Accepted: June 14, 2022
Published online: June 28, 2022

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: https://www.karger.com/CHE

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