Clinical and Pathologic Complete Response to Gefitinib in a Patient with SqCLC Harboring EGFR p.E746_S752delinsV Mutation
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Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
Published on: August 11, 2017
Weitao Zhuang1,2, Chao Zhang3, Yong Tang1
1Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China.
Abstract:
Development of targeted therapies for squamous cell lung cancer (SqCLC) is currently limited by the prevalence of activating mutations and their predicting power of treatment efficacy. In the present study, we describe a case of treatment-naïve stage IIIB SqCLC that harbored a rare epidermal growth factor receptor (EGFR) p.E746_S752delinsV mutation with clinical complete response to neoadjuvant gefitinib. Pathological complete response was confirmed after surgical resection. No disease recurrence was documented after 20-month follow-up. This report suggested that first-generation EGFR tyrosine kinase inhibitor (TKI) could be an option in neoadjuvant context for advanced SqCLC patients harboring EGFR p.E746_S752delinsV mutation and highlighted the clinical benefits of EGFR testing in SqCLC patients who are females and never/former light smokers.
Insights
A rare EGFR mutation in advanced squamous cell lung cancer (SqCLC) responded completely to neoadjuvant gefitinib. This suggests EGFR testing benefits select SqCLC patients, particularly females and light smokers.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Targeted therapy development for squamous cell lung cancer (SqCLC) faces challenges due to limited actionable mutations and predicting treatment efficacy.
- Epidermal Growth Factor Receptor (EGFR) mutations are crucial targets in non-small cell lung cancer, but their role in SqCLC is less defined.
Observation:
- A case of treatment-naïve stage IIIB SqCLC with a rare EGFR p.E746_S752delinsV mutation was identified.
- The patient received neoadjuvant gefitinib, a first-generation EGFR tyrosine kinase inhibitor (TKI).
Findings:
- The patient achieved a clinical complete response to neoadjuvant gefitinib.
- Pathological complete response was confirmed post-surgical resection.
- No disease recurrence was observed during a 20-month follow-up period.
Implications:
- First-generation EGFR TKIs may be a viable neoadjuvant treatment option for advanced SqCLC patients with the specific EGFR p.E746_S752delinsV mutation.
- EGFR mutation testing could offer clinical benefits for SqCLC patients, especially in specific demographics like females and never/former light smokers.
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