Related Experiment Video
Updated: Jul 13, 2026
Establishment and Characterization of Three Afatinib-resistant Lung Adenocarcinoma PC-9 Cell Lines Developed with Increasing Doses of Afatinib
Published on: June 26, 2019
Erlotinib response of EGFR-mutant gefitinib-resistant non-small-cell lung cancer
John Wen-Cheng Chang1, Chun-Liang Chou, Shiu-Feng Huang
1Department of Hematology-Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan. wen1902@hotmail.com
Purpose:
Failure to gefitinib is generally believed to be associated with cross-resistance to other epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI). Here we report a case whose active EGFR-mutant NSCLC responded to erlotinib treatment.
Patient And Methods:
Lung specimen was obtained during diagnostic procedures from a 41-year-old Taiwanese male smoker with adenocarcinoma. He received cisplatin-based chemotherapy following craniotomy to remove his brain metastasis. Tumor progressed in both lung and left adrenal gland. He underwent second-line docetaxel chemotherapy. Tumor progressed again 7 months later. He was subsequently treated with gefitinib 250mg QD. Complete regression of the lung tumor and partial response of the left adrenal gland mass was achieved. Nine months later, the left lower lobe lung tumor and left adrenal gland tumor progressed. A lung biopsy from the left lower lobe disclosed an adenocarcinoma which harbored an in-frame deletion in exon 19 (heterozygous delE746-A750) of EGFR without a second mutation such as T790M in exon 20. Subsequent erlotinib 150mg QD was administered. He experienced grade 1 skin rash, diarrhea and paronychia following erlotinib.
Results:
This patient achieved a partial response to erlotinib treatment. He remained on erlotinib for a total of 18 months until the left adrenal gland tumor progressed.
Conclusions:
This case demonstrated that NSCLC bearing in-frame deletion in exon 19 of EGFR may respond to erlotinib treatment following gefitinib failure.
Insights
This case report shows that erlotinib can be effective in treating non-small cell lung cancer (NSCLC) with EGFR mutations, even after gefitinib treatment failure. This finding offers a potential treatment option for patients with advanced EGFR-mutant NSCLC.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Non-small cell lung cancer (NSCLC) with activating epidermal growth factor receptor (EGFR) mutations is often treated with EGFR tyrosine kinase inhibitors (TKIs).
- Gefitinib is a first-generation EGFR-TKI, and resistance to it is common, often leading to cross-resistance with other EGFR-TKIs.
- Understanding treatment responses after initial TKI failure is crucial for managing advanced NSCLC.
Observation:
- A 41-year-old male with advanced NSCLC and an EGFR exon 19 deletion (delE746-A750) initially responded to gefitinib.
- Following disease progression on gefitinib, the patient was treated with erlotinib.
- The patient experienced mild side effects including rash and diarrhea with erlotinib.
Findings:
- The patient achieved a partial response to erlotinib, with the adrenal gland tumor progressing after 18 months of treatment.
- This case demonstrates that erlotinib can be an effective treatment option in NSCLC harboring EGFR exon 19 deletions, even after progression on gefitinib.
- No secondary T790M mutation was detected in the EGFR gene.
Implications:
- This case suggests that cross-resistance between gefitinib and erlotinib may not be absolute for all EGFR mutations.
- Erlotinib may be a viable treatment option for patients with EGFR-mutant NSCLC who have progressed on gefitinib.
- Further investigation into treatment sequencing and resistance mechanisms in EGFR-mutant NSCLC is warranted.
More Related Videos
Related Concept Videos
02:38Mitogens and the Cell Cycle
02:57Targeted Cancer Therapies
There are several types of targeted therapies against specific...