Response to Afatinib in a Patient with Non-Small Cell Lung Cancer Harboring HER2 R896G Mutation: A Case Report
Ling Lin1, Hongfei Ge2, Zhengqing Yan3
1Department of Respiratory Medicine, Taizhou Hospital of Wenzhou Medical University, Taizhou, Zhejiang 317000, People's Republic of China.
Purpose:
HER2 mutations are identified in approximately 2% of non-small-cell lung cancer (NSCLC) cases; however, until now, there are no approved standard targeted therapy for NSCLC patients harboring HER2 mutations.
Case Presentation:
We present a 63-year-old male with a long smoking history, who was diagnosed with stage IV squamous cell lung cancer. After the failures of two lines of treatment with carboplatin plus gemcitabine and nidaplatin plus docetaxel, in turn, the patient received a next-generation sequencing of circulating tumor DNA to seek for potential treatment opportunities. A HER2 R896G mutation was identified with an allelic fraction of 50.77%. The patient received afatinib 40 mg a day and reached a partial response after two months of treatment. The progression-free survival was more than 14 months and the treatment of afatinib was ongoing. During the treatment, treatment-related paronychia and stomatitis occurred and relieved without any management.
Conclusion:
This is the first case report describing a NSCLC patient harboring a rare HER2 R896G mutation who responds to afatinib. This case suggests that afatinib might be efficacious in NSCLC patients harboring HER2 R896G mutations, and these results need to be further studied in prospective clinical trials.
Insights
This case report details a non-small cell lung cancer (NSCLC) patient with a rare HER2 R896G mutation who showed a positive response to afatinib. This suggests afatinib may be an effective targeted therapy for NSCLC with this specific mutation.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Non-small cell lung cancer (NSCLC) harbors HER2 mutations in about 2% of cases.
- Currently, no standard targeted therapy is approved for NSCLC patients with HER2 mutations.
Observation:
- A 63-year-old male with stage IV squamous cell lung cancer, a former smoker, received afatinib after two prior treatment failures.
- Next-generation sequencing identified a HER2 R896G mutation with a high allelic fraction (50.77%).
Findings:
- The patient achieved a partial response to afatinib (40 mg daily) within two months.
- Progression-free survival exceeded 14 months, with treatment ongoing.
- Afatinib treatment resulted in manageable side effects of paronychia and stomatitis.
Implications:
- This is the first reported case of a NSCLC patient with a HER2 R896G mutation responding to afatinib.
- Afatinib shows potential efficacy for NSCLC harboring the HER2 R896G mutation.
- Further prospective clinical trials are warranted to validate these findings.
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