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Response to Afatinib in a Patient with NSCLC Harboring Novel EGFR Exon 20 Insertion Mutations

Ling Lin1, Xiaomai Wu1, Shuangquan Yan1

  • 1Department of Respiratory Medicine, Taizhou Hospital of Wenzhou Medical University, Taizhou, People's Republic of China.

Oncotargets and Therapy
|October 16, 2020
PubMed
Abstract

Insights

Most EGFR exon 20 insertion mutations resist TKIs. However, a rare EGFR N771delinsKG mutation in lung adenocarcinoma responded to afatinib, showing treatment heterogeneity.

Area of Science:

  • Oncology
  • Genetics
  • Pharmacology

Background:

  • Most epidermal growth factor receptor (EGFR) exon 20 insertion (ex20ins) mutations confer resistance to tyrosine kinase inhibitors (TKIs).
  • Identifying specific EGFR ex20ins subtypes is crucial for predicting non-small cell lung cancer (NSCLC) patient response to TKIs.

Observation:

  • A 71-year-old Chinese female with advanced lung adenocarcinoma presented with an EGFR ex20ins (N771delinsKG) mutation.
  • The patient received first-line afatinib therapy, achieving a partial radiological response with a 10-month progression-free survival.

Findings:

  • This case report details the first instance of EGFR N771delinsKG lung adenocarcinoma.
  • The patient's response to afatinib highlights the heterogeneity of clinical outcomes for EGFR ex20ins-mutant NSCLC.

Implications:

  • The findings suggest that certain rare EGFR ex20ins mutations may respond to TKIs, contrary to general resistance patterns.
  • Further prospective studies are needed to validate these observations and explore treatment strategies for specific EGFR ex20ins subtypes.
Keywords:
EGFR exon 20 insertionsafatiniblung adenocarcinomanext generation sequencing

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