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A Combined 3D Tissue Engineered In Vitro/In Silico Lung Tumor Model for Predicting Drug Effectiveness in Specific Mutational Backgrounds
Published on: April 6, 2016
Lung adenocarcinoma harboring rare epidermal growth factor receptor L858R and V834L mutations treated with icotinib:
Shu-Sen Zhai1, Hui Yu2, Tian-Tian Gu2
1Oncology Section, PLA Strategic Support Force Characteristic Medical Center, Beijing 100101, China.
Background:
Epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors are widely used for the treatment of non-small-cell lung cancer with EGFR mutations. However, patients with rare, even compound EGFR mutations have different responses to EGFR-tyrosine-kinase inhibitors, which bring uncertainty to clinical treatment.
Case Summary:
A 45-year-old female patient presented with a 3-mo history of cough and white sputum without chest pain. Chest computed tomography revealed lung space-occupying lesions and multiple lymphadenectasis. Bronchoscopy and pathology suggested lung adenocarcinoma. Compound variation of EGFR gene (exon 21 L858R/V834L) was detected in both tissue and circulating tumor deoxyribonucleic acid samples. As a result of next-generation sequencing and her family's wishes, the patient was given oral treatment with icotinib hydrochloride (125 mg/d, tid) from March 21, 2019 and has achieved stable disease for the last 1 year.
Conclusion:
Non-small cell lung adenocarcinoma with EGFR L858R/V834L was treated successfully with icotinib, and it may be a new medication treatment option.
Insights
This study shows icotinib effectively treated a patient with non-small cell lung adenocarcinoma harboring rare compound EGFR mutations (L858R/V834L). This suggests icotinib as a potential new treatment option for such cases.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors are standard for EGFR-mutated non-small cell lung cancer.
- Rare and compound EGFR mutations present treatment challenges due to variable responses to existing therapies.
Observation:
- A 45-year-old female with lung adenocarcinoma presented with cough and sputum.
- Imaging revealed lung lesions and lymphadenectasis; bronchoscopy confirmed adenocarcinoma.
- Next-generation sequencing identified compound EGFR mutations (exon 21 L858R/V834L) in tumor and ctDNA.
Findings:
- The patient received oral icotinib hydrochloride (125 mg, tid) for over a year.
- Stable disease was achieved and maintained for 1 year, indicating treatment efficacy.
- This case demonstrates successful treatment of non-small cell lung adenocarcinoma with EGFR L858R/V834L.
Implications:
- Icotinib hydrochloride shows promise as a novel therapeutic option for non-small cell lung adenocarcinoma with rare compound EGFR mutations.
- This case highlights the importance of comprehensive genomic profiling for guiding targeted therapy in lung cancer.
- Further research is warranted to explore icotinib's efficacy in a broader patient population with similar genetic profiles.
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