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A Patient of Advanced NSCLC with a New EGFR Exon 19 Insertion Mutation and its Response to EGFR-TKIs
Ning Zhu1, Caixia Dong1, Shanshan Weng1
1Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, China.
Abstract:
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC) harbouring common EGFR mutations. However, about 10% of EGFR mutations are uncommon mutations and their response to EGFR-TKIs remains unclear. The present case reports a 75-year, female patient with advanced NSCLC, presenting with a new subtype of EGFR exon 19 insertion mutation (IPVAIL insertion), who showed obvious symptom improvement after EGFR-TKIs treatment but a relatively short time of progression-free survival (PFS) and succumbed to tumor 133 days (4.4 months) after diagnosis. In conclusion, patients harbouring new subtype of EGFR exon 19 insertion mutations, IPVAIL insertion may have a poor prognosis. Further experiences are required to characterise these uncommon mutations.
Insights
Uncommon EGFR exon 19 insertion mutations, like IPVAIL, offer limited progression-free survival in advanced non-small-cell lung cancer. This suggests a potentially poor prognosis for patients with these rare mutations.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are standard for advanced non-small-cell lung cancer (NSCLC) with common EGFR mutations.
- Uncommon EGFR mutations, comprising about 10% of cases, have unclear responses to EGFR-TKIs.
Observation:
- A case report details a 75-year-old female with advanced NSCLC and a novel EGFR exon 19 IPVAIL insertion mutation.
- The patient experienced symptom improvement with EGFR-TKIs but had a short progression-free survival (PFS) of 133 days.
Findings:
- The IPVAIL insertion represents a new subtype of EGFR exon 19 mutation.
- This specific mutation may be associated with a poor prognosis in advanced NSCLC patients.
Implications:
- Patients with the IPVAIL insertion mutation may face a poorer prognosis despite initial response to EGFR-TKIs.
- Further research and clinical experience are needed to fully characterize uncommon EGFR mutations and guide treatment strategies.
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