Osimertinib as treatment for EGFR exon 20 insertion-positive lung adenocarcinoma
Chihiro Murano1, Akira Igarashi2, Keiko Yamauchi2
1Postgraduate Clinical Training Center, Yamagata University Hospital, Yamagata, Japan.
Abstract:
A 20-year-old woman was diagnosed with stage 4 lung adenocarcinoma with an epidermal growth factor receptor (EGFR) exon 20 insertion gene mutation. Although the patient underwent chemotherapy, her lesions progressed. Liquid biopsy for EGFR T790M mutation showed negative results. After administering osimertinib, reduction of the lesions at the primary site was observed, and the patient's respiratory condition improved. Previous reports showing successful treatment of EGFR exon 20 insertion-positive lung adenocarcinoma with the standard osimertinib dose of 80 mg are limited. The present case demonstrated that osimertinib could be a possible treatment option for EGFR exon 20 insertion-positive lung adenocarcinoma.
Insights
This case study highlights a patient with advanced lung adenocarcinoma and an EGFR exon 20 insertion mutation. Osimertinib treatment led to tumor reduction and improved respiratory function, suggesting its potential efficacy.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Lung adenocarcinoma (LUAD) is a major cause of cancer-related mortality.
- Epidermal Growth Factor Receptor (EGFR) mutations are key drivers in LUAD, with exon 20 insertions representing a challenging subset.
- Standard chemotherapy often shows limited efficacy in advanced LUAD with specific EGFR mutations.
Observation:
- A young woman with stage 4 LUAD presented with an EGFR exon 20 insertion mutation.
- Despite prior chemotherapy, the patient experienced disease progression.
- Liquid biopsy confirmed the absence of the EGFR T790M resistance mutation.
Findings:
- Administration of osimertinib resulted in significant reduction of primary tumor lesions.
- The patient's respiratory symptoms showed marked improvement following osimertinib treatment.
- This case adds to limited evidence supporting the efficacy of osimertinib in EGFR exon 20 insertion-positive LUAD.
Implications:
- Osimertinib may represent a viable therapeutic option for patients with EGFR exon 20 insertion-mutated LUAD.
- This finding warrants further investigation in clinical trials to establish osimertinib's role in this specific patient population.
- Personalized medicine approaches, guided by molecular profiling, are crucial for optimizing LUAD treatment outcomes.
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